Organization
LOS ANGELES SHERIFF'S DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA OFELIA CRUZ DE PORTILLO NP (NURSE PRACTITIONER)
(213) 893-5455
Entity
Organization
Contact information
Practice address
450 BAUCHET ST, LOS ANGELES, CA 90012-2907
(213) 893-5455
(213) 633-4663
Mailing address
19400 LANARK ST, RESEDA, CA 91335-1013
(818) 885-0864
(818) 885-0864
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
586319 NPC16628
CA
Other
Enumeration date
05/12/2008
Last updated
05/12/2008
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