Ronald Cotliar MD Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G25069 Issued in CA

Legal business name

RONALD COTLIAR MD INC

Practice address

13420 Newport Ave
Suite G
Tustin, CA 92780-3745

Phone

(714) 731-0061

Fax

(714) 731-0164

NPI assigned

Apr 26, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Evelyn T Riley

Title

Office Manager

Phone

(714) 731-0061

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273449600000",
    "number": "1962729269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13420 NEWPORT AVE",
            "address_2": "SUITE G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803745",
            "telephone_number": "714-731-0061",
            "fax_number": "714-731-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13420 NEWPORT AVE",
            "address_2": "SUITE G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803745",
            "telephone_number": "714-731-0061",
            "fax_number": "714-731-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD COTLIAR MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-05-10",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "714-731-0061"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G25069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Tustin, CA
• Providers in Tustin, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.