Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E3956 | CA |
Y | 222Z00000X | Podiatrist | E3956 | CA |
NPI | 1033168877 |
---|---|
Provider Name | Dr. Joseph Michael Cortez |
First Address | Simi Valley, CA 93065-2868 |
Second Address | Simi Valley, CA 93065-5803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 22/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E39560 | (05) | CA |
U51840 | (02) | CA |