Provider Demographics
NPI:1881608412
Name:ORTEGA, JOSEPH A (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 TEXAS ST STE 301
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3724
Mailing Address - Country:US
Mailing Address - Phone:619-296-5655
Mailing Address - Fax:619-296-7647
Practice Address - Street 1:5005 TEXAS ST STE 301
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3724
Practice Address - Country:US
Practice Address - Phone:619-296-5655
Practice Address - Fax:619-296-7647
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24190111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor