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Individual

DR. PAUL FORTALEZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
6350 LAUREL CANYON BLVD STE 205, NORTH HOLLYWOOD, CA 91606-3278
(818) 325-2090
Mailing address
6350 LAUREL CANYON BLVD STE 205, NORTH HOLLYWOOD, CA 91606-3278
(818) 325-2090

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
20A6703
CA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
20A6703
CA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
DO2271
NV

Other

Enumeration date
04/24/2007
Last updated
10/22/2019
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