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Organization
LOS ANGELES SHERIFF'S DEPARTMENT
Active
Organization
LOS ANGELES SHERIFF'S DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA OFELIA CRUZ DE PORTILLO NP (NURSE PRACTITIONER)
(213) 893-5455
Entity
Organization
Contact information
Practice address
450 BAUCHET ST, LOS ANGELES, CA 90012-2907
(213) 893-5455
(213) 633-4663
Mailing address
19400 LANARK ST, RESEDA, CA 91335-1013
(818) 885-0864
(818) 885-0864
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
586319 NPC16628
CA
Other
Enumeration date
05/12/2008
Last updated
05/12/2008
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