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1639852635
ALFREDO MANUEL PORTILLO
APPLE VALLEY, CA
NPI
1639852635
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: CA 95026013)
Enumeration Date
2023-08-08
Last Update Date
2023-08-08
Business Address
ALFREDO MANUEL PORTILLO AG-ACNP
18300 CA-18
APPLE VALLEY, CA 92307
Phone number: 760-242-2311
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Mailing Address
ALFREDO MANUEL PORTILLO AG-ACNP
18310 CA-18 SUITE B
APPLE VALLEY, CA 92307
Phone number: 760-998-2312
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