Individual
JEWELS N PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3455 PERCY ST, LOS ANGELES, CA 90023-1716
(323) 268-2100
Mailing address
3455 PERCY ST, LOS ANGELES, CA 90023-1716
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
289363
CA
Other
Enumeration date
03/06/2020
Last updated
03/06/2020
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