Portnoff, Jon Stephen
Portnoff, Jon Stephen is an individual health care provider with primary practice located at 260 Hospital Dr Suite 207, Ukiah CA 95482-4533. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Portnoff, Jon Stephen can be contacted via phone (707) 463-2400.Contact Information
Primary practice address
260 Hospital Dr Suite 207
Ukiah CA 95482-4533
Phone: (707) 463-2400
Fax: (707) 463-3520
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | A43219 | California |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | A43219 | California |
Profile Details
| NPI number | 1609874445 |
|---|---|
| LBN Legal business name | Portnoff, Jon Stephen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 13th, 2005 |
| Last updated | Oct 25th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609874445 | NPPES |
| California | MEDICAID | 00A432190 | |
| California | Other | ZZZ00872Z | |
| California | Other | 00A432190 | |
| California | Other | 060020995 |
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