Provider Demographics
NPI:1285934695
Name:ORTIZE, JAMES ALAN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALAN
Last Name:ORTIZE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 COUNTRY CLUB BLVD
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-3957
Mailing Address - Country:US
Mailing Address - Phone:209-461-5560
Mailing Address - Fax:209-461-5566
Practice Address - Street 1:2808 COUNTRY CLUB BLVD
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-3957
Practice Address - Country:US
Practice Address - Phone:209-461-5560
Practice Address - Fax:209-461-5566
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29092183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist