DR. Richard Alan Portillo, O.D.

NPI #1255450524 in Modesto, California

Provider Information

NPI Number: 1255450524
Entity Type: Individual
Name: DR. Richard Alan Portillo, O.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Mar 28, 2007
Last Updated: Mar 30, 2012

Practice Location

Address: 1624 I ST
City: Modesto
State: California
ZIP Code: 95354-1122
Phone: (209) 578-4885

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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