Provider Demographics
NPI:1588371058
Name:CORTES, JOSE MANUEL JR
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MANUEL
Last Name:CORTES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19321 ADDIS ST
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2326
Mailing Address - Country:US
Mailing Address - Phone:714-492-4039
Mailing Address - Fax:
Practice Address - Street 1:19321 ADDIS ST
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-2326
Practice Address - Country:US
Practice Address - Phone:714-492-4039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic