Individual
JORGE ANTONIO PEREZ-ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1954 KOMET WAY, SAN DIEGO, CA 92111-5743
(619) 547-4749
Mailing address
12012 LEMON CREST DR, LAKESIDE, CA 92040-3712
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000039790
CA
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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