Individual
CARLOS-MIGUEL DEL PORTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
465 W PUTNAM AVE, PORTERVILLE, CA 93257-3320
(559) 784-1110
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
95002077
CA
Other
Enumeration date
05/26/2023
Last updated
05/26/2023
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