Provider Demographics
NPI:1346078789
Name:DAHLA-ORTIZ PROFESSIONAL HEALTHCARE CONSULTATION PLLC
Entity type:Organization
Organization Name:DAHLA-ORTIZ PROFESSIONAL HEALTHCARE CONSULTATION PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER, DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIANELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ-CHAVES DAHLA
Authorized Official - Suffix:
Authorized Official - Credentials:HMA, MHA
Authorized Official - Phone:408-896-3215
Mailing Address - Street 1:PO BOX 251
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95052-0251
Mailing Address - Country:US
Mailing Address - Phone:408-896-3215
Mailing Address - Fax:
Practice Address - Street 1:45 WILDFLOWER DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4332
Practice Address - Country:US
Practice Address - Phone:408-896-3215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-25
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or Welfare
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
No282N00000XHospitalsGeneral Acute Care Hospital