Organization
ROBERT L. PORTILLO, D.P.M., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNIE KAKEHASHI (OFFICE MANAGER)
(310) 319-0029
Entity
Organization
Contact information
Practice address
1304 15TH ST, SUITE 218, SANTA MONICA, CA 90404-1809
(310) 319-0029
(310) 458-2516
Mailing address
1304 15TH ST, SUITE 218, SANTA MONICA, CA 90404-1809
(310) 319-0029
(310) 458-2516
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E1381
CA
Other
Enumeration date
02/01/2008
Last updated
02/01/2008
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