Provider Demographics
NPI:1841445251
Name:JAMIE R CORTES MD INC
Entity type:Organization
Organization Name:JAMIE R CORTES MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:O
Authorized Official - Last Name:CORTES
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:510-532-1070
Mailing Address - Street 1:2700 INTERNATIONAL
Mailing Address - Street 2:SUITE 33
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-1539
Mailing Address - Country:US
Mailing Address - Phone:510-532-1070
Mailing Address - Fax:510-532-3166
Practice Address - Street 1:2700 INTERNATIONAL BLVD
Practice Address - Street 2:SUITE 33
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-1520
Practice Address - Country:US
Practice Address - Phone:510-532-1070
Practice Address - Fax:510-532-3166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63927207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A639270Medicaid
CA00A639270Medicaid