Elijah Nathaniel Fortes
Rehabilitation Practitioner in Chula Vista, CA. Individual provider (NPI-1).
NPI number1851059596
StatusActive
Last updated in NPPESMar 27, 2025
Details
- NPI
- 1851059596
- Entity type
- Individual (NPI-1)
- Name
- Elijah Nathaniel Fortes
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 30, 2021
- Certification date
- Mar 27, 2025
- Last updated
- Mar 27, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | – | – | Yes |
Practice location
1196 3rd AveChula Vista, CA 91911-3131
Phone 619-427-4661
Mailing address
1196 3rd AveChula Vista, CA 91911-3131
Phone 619-427-4661
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