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General NPI Number Information
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NPI Number | 1922269091
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Entity Type | Individual
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Provider Name | STEVEN CHRISTOPHER PORTALE M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2008
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 2330 UTAH AVE STE 200
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City | EL SEGUNDO
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State | CA
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Zip | 90245-4817
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Country | US
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Telephone | 813-250-2506
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Fax | 813-594-5907
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Provider Business Mailing Address
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Address Line | 101 W BEACH PL APT 1700
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City | TAMPA
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State | FL
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Zip | 33606-2336
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Country | US
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Telephone | 609-709-7667
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME1488860
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License Number State | FL
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