Individual
EUGENE PORTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6305 WOODMAN AVE, VAN NUYS, CA 91401-2346
(818) 908-4999
Mailing address
5255 RIVERTON AVE, NORTH HOLLYWOOD, CA 91601-5544
(818) 331-0943
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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