Individual
DR. GUILLERMO PORTILLO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 E LEHIGH AVE, DEPARTMENT OF PSYCHIATRY, PHILADELPHIA, PA 19125-1012
(215) 707-1200
Mailing address
100 E LEHIGH AVE, DEPARTMENT OF PSYCHIATRY, PHILADELPHIA, PA 19125-1012
(215) 707-1200
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD437521
PA
2084P0800X
Psychiatry Physician
Primary
MT191276
PA
Other
Enumeration date
07/15/2008
Last updated
02/08/2010
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