Provider Demographics
NPI:1548462567
Name:HOLTZMAN, AURY LOR (MD)
Entity type:Individual
Prefix:DR
First Name:AURY
Middle Name:LOR
Last Name:HOLTZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 308
Mailing Address - Street 2:
Mailing Address - City:MIDWAY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92655-0308
Mailing Address - Country:US
Mailing Address - Phone:714-842-4946
Mailing Address - Fax:714-842-4946
Practice Address - Street 1:220 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-5154
Practice Address - Country:US
Practice Address - Phone:714-842-4946
Practice Address - Fax:714-842-4946
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43970207QA0505X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Not Answered207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine