Provider Demographics
NPI:1063714053
Name:V.M.CORTES,M.D.,INC.
Entity type:Organization
Organization Name:V.M.CORTES,M.D.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MILAGROSA
Authorized Official - Middle Name:MADARIETA
Authorized Official - Last Name:LAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-965-6449
Mailing Address - Street 1:1557 E AMAR RD STE F
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1678
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1557 E AMAR RD STE F
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-1678
Practice Address - Country:US
Practice Address - Phone:626-965-6449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A28567Medicare UPIN