# ROBERT L. PORTILLO, D.P.M., INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942488879
- **Authorized official:** MS. ANNIE KAKEHASHI (OFFICE MANAGER)
- **Authorized official phone:** (310) 319-0029

## Contact information

- **Practice address:** 1304 15TH ST, SUITE 218, SANTA MONICA, CA 90404-1809
- **Practice address phone:** (310) 319-0029
- **Practice address fax:** (310) 458-2516
- **Mailing address:** 1304 15TH ST, SUITE 218, SANTA MONICA, CA 90404-1809
- **Mailing address phone:** (310) 319-0029
- **Mailing address fax:** (310) 458-2516

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | E1381 | CA | Yes |

## Other

- **Enumeration date:** 02/01/2008
- **Last updated:** 02/01/2008