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Contact Information

MARY D FORTIN
710 LAWERENCE EXPRESSWAY, DEPT.174
SANTA CLARA, CA95051
 Phone: 408-851-1495
 Fax: 408-851-1499
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

2251P0200X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for MARY D FORTIN · (Female)

NPI # 1215091947
Status Active
Credentials
Entity Individual
Enumeration date 12/20/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • CA License # PT10606
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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