Individual
MRS. EILDA PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2100 POWELL ST STE 920, EMERYVILLE, CA 94608-1844
(510) 350-2600
Mailing address
2100 POWELL ST STE 920, EMERYVILLE, CA 94608-1844
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA19764
CA
Other
Enumeration date
07/14/2008
Last updated
04/02/2010
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