Provider Demographics
NPI:1922322874
Name:ORTIZ-RUBIO LOPEZ-PORTILLO, PAULINA MARGARITA (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULINA
Middle Name:MARGARITA
Last Name:ORTIZ-RUBIO LOPEZ-PORTILLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PAULINA
Other - Middle Name:
Other - Last Name:ORTIZ-RUBIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-1098
Mailing Address - Country:US
Mailing Address - Phone:619-881-9165
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA1427772080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program