Richard A Portillo O D A Professional Optometric Corporation

NPI No. 1285963769 - Point of Service

 

Contacts & Locations

Practice Address

  • 1624 I St
    Modesto, California 95354, US
  • Phone: (209) 578-4885

Office Address

  • Po Box 1743
    Modesto, California 95353, US
  • Phone: (209) 578-4885

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Richard A Portillo O D A Professional Optometric Corporation Information

Richard A Portillo O D A Professional Optometric Corporation is registered as an Organization entity type. Richard A Portillo O D A Professional Optometric Corporation NPI is 1285963769. You can also contact Richard A Portillo O D A Professional Optometric Corporation via phone number (209) 578-4885. The provider is listed as Point of Service.

About NPI No.

  • NPI: 1285963769 (Organization)
  • Name: Richard A Portillo O D A Professional Optometric Corporation
  • Organization: Hospitals, home health agencies, ambulance companies, health maintenance organizations, durable medical equipment suppliers, pharmacies, etc.
  • Taxonomy

  • Taxonomy code: 305S00000X
  • Taxonomy specialization: Point of Service
  • Primary taxonomy: Yes
  • License

  • License number: 7865T
  • License state: California State License
  • Enumeration date: December 13, 2009
  • Last Update date: September 18, 2012

Authorized Official

  • Dr. Richard ALAN Portillo O.D.
  • Title: President
  • Phone: (209) 578-4885

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