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Individual

DR. JON M PORTIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1380 LUSITANA ST, STE 714, HONOLULU, HI 96813-2449
(808) 528-5333
Mailing address
1380 LUSITANA ST, STE 714, HONOLULU, HI 96813-2443
(808) 528-5333

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4643
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01821501
HI
Enumeration date
09/04/2006
Last updated
02/20/2008
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