| NPI | 1548845167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD J PORTOCARRERO Authorized Official 626-461-5406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Enumeration Date | 2021-03-15 |
| Last Update Date | 2021-04-14 |