RICHARD A PORTILLO O D A PROFESSIONAL OPTOMETRIC CORPORATION NPI 1285963769

NPI Information

RICHARD A PORTILLO O D A PROFESSIONAL OPTOMETRIC CORPORATION is a point of service in Modesto, CA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. RICHARD A PORTILLO O D A PROFESSIONAL OPTOMETRIC CORPORATION NPI is 1285963769. The provider is registered as an organization entity type.

The provider's business location address is:

1624 I ST
MODESTO, CA
ZIP 95354-122
Phone: (209) 578-4885

The provider's authorized official is Richard Alan Portillo .
The authorized official title is President and has the following contact phone number (209) 578-4885.

The enumeration date for this NPI number is 12/13/2009 and was last updated on 9/18/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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