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Individual
JASON PORTILLO
Active
Individual
JASON PORTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
A125714
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114003
SID # 114003
CA
Enumeration date
01/25/2012
Last updated
11/04/2021
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