Provider Demographics
NPI:1912636556
Name:CORTEZ NEUROSURGERY & NEUROVASCULAR SERVICES PC
Entity Type:Organization
Organization Name:CORTEZ NEUROSURGERY & NEUROVASCULAR SERVICES PC
Other - Org Name:CORTEZ NEUROSURGERY & NEUROVASCULAR SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NEUROSURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:ADRIANO
Authorized Official - Last Name:CORTEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:909-809-2101
Mailing Address - Street 1:508 CAJON ST STE B
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-5982
Mailing Address - Country:US
Mailing Address - Phone:909-283-4101
Mailing Address - Fax:909-283-4105
Practice Address - Street 1:508 CAJON ST STE B
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5982
Practice Address - Country:US
Practice Address - Phone:909-283-4101
Practice Address - Fax:909-283-4105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular NeurologyGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1687071135Medicaid