Basic Information
| Provider Information | |||||||||
| NPI: | 1174905855 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ORTEGA | ||||||||
| FirstName: | AMBER | ||||||||
| MiddleName: | JO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8881 FLETCHER PKWY STE 105 | ||||||||
| Address2: | |||||||||
| City: | LA MESA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919423132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8584995715 | ||||||||
| FaxNumber: | 6194629625 | ||||||||
| Practice Location | |||||||||
| Address1: | 8701 CUYAMACA ST | ||||||||
| Address2: | |||||||||
| City: | SANTEE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8584992715 | ||||||||
| FaxNumber: | 6195688080 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2015 | ||||||||
| LastUpdateDate: | 10/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A147945 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.