Provider Demographics
NPI:1669176459
Name:ORTIZ, JULIAN ENRIQUE (DO)
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:ENRIQUE
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2081 WOODS AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-5913
Mailing Address - Country:US
Mailing Address - Phone:323-774-7896
Mailing Address - Fax:
Practice Address - Street 1:2081 WOODS AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-5913
Practice Address - Country:US
Practice Address - Phone:323-774-7896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58.033499207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services