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Individual

ERIC ORTIZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8875 COSTA VERDE BLVD, SAN DIEGO, CA 92122-6656
(505) 917-8018
Mailing address
P.O. BOX 249 #86086, ALBUQUERQUE, NM 87103
(505) 917-8018

Taxonomy

Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary

Other

Enumeration date
09/27/2021
Last updated
09/27/2021
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