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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