Organization
PORTALS HOUSE INC
Active
Organization
PORTALS HOUSE INC
Active
Other names
Pacific Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY ANN PAYTON (PROGRAM AIDE)
(213) 639-0251
Entity
Organization
Contact information
Practice address
2500 WILSHIRE BLVD STE 500, LOS ANGELES, CA 90057-4310
(213) 639-0251
Mailing address
2500 WILSHIRE BLVD STE 500, LOS ANGELES, CA 90057-4310
(213) 639-0251
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
06/16/2008
Last updated
06/16/2008
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