Individual
BRENT LELAND PORTEOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2500 ALHAMBRA AVE, MARTINEZ, CA 94553-3156
(925) 370-5200
Mailing address
2500 ALHAMBRA AVE, MARTINEZ, CA 94553-3156
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12969
CA
Other
Enumeration date
09/17/2013
Last updated
09/17/2013
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