Provider Demographics
NPI:1841503570
Name:PORTOCARRERO, DONALD J (DO)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:PORTOCARRERO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:122A E FOOTHILL BLVD UNIT 304
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-2505
Mailing Address - Country:US
Mailing Address - Phone:626-461-5408
Mailing Address - Fax:626-461-5436
Practice Address - Street 1:623 W DUARTE RD STE 8
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7349
Practice Address - Country:US
Practice Address - Phone:626-461-5408
Practice Address - Fax:626-461-5436
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2024-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A11058207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology