Provider Demographics
NPI:1306271762
Name:HORTZ, JULIAN (PHD)
Entity type:Individual
Prefix:DR
First Name:JULIAN
Middle Name:
Last Name:HORTZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 JACK NORTHROP AVE STE 11729
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-4433
Mailing Address - Country:US
Mailing Address - Phone:323-522-4402
Mailing Address - Fax:
Practice Address - Street 1:19231 VICTORY BLVD STE 452
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-6361
Practice Address - Country:US
Practice Address - Phone:323-522-4402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-04
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA00048842085U0001X, 237600000X, 2083P0901X
TXA0004884246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant