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1306235957
MICHAEL RICHARD PORTILLO
SONORA, CA
NPI
1306235957
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: CA A144432)
Enumeration Date
2015-01-21
Last Update Date
2017-12-14
Business Address
Dr. MICHAEL RICHARD PORTILLO M.D.
680 GUZZI LN STE 106
SONORA, CA 95370-5288
Phone number: 209-536-5770
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Mailing Address
Dr. MICHAEL RICHARD PORTILLO M.D.
PO BOX 655
TWAIN HARTE, CA 95383-0655
Phone number: 209-206-2266
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