Individual
DR. PAUL WALLACE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2248 PARK BLVD., PALO ALTO, CA 94306
(650) 328-4411
Mailing address
2248 PARK BLVD., PALO ALTO, CA 94306
(650) 328-4411
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
Primary
33060
CA
111NR0400X
Rehabilitation Chiropractor
33060
CA
111NX0100X
Occupational Health Chiropractor
33060
CA
Other
Enumeration date
09/10/2015
Last updated
08/14/2023
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