Bortniker, Ethan Israel

Bortniker, Ethan Israel is an individual health care provider with primary practice located at 200 W Arbor Dr , San Diego CA 92103-9000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Bortniker, Ethan Israel can be contacted via phone (800) 926-8273.

Contact Information

Primary practice address
200 W Arbor Dr San Diego CA 92103-9000
Phone: (800) 926-8273
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X A155188 California

Profile Details

NPI number 1396905576
LBN Legal business name Bortniker, Ethan Israel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2008
Last updated Jan 30th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396905576 NPPES
Massachusetts MEDICAID 110089060A

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