Individual
DR. JACOB STEPHEN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7117 BROCKTON AVE, RIVERSIDE, CA 92506-2658
(951) 782-3685
(951) 784-3256
Mailing address
7117 BROCKTON AVE, RIVERSIDE, CA 92506-2658
(951) 782-3685
(951) 784-3256
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
5426
OK
208000000X
Pediatrics Physician
Primary
20A15727
CA
208000000X
Pediatrics Physician
5426
OK
Other
Enumeration date
03/14/2012
Last updated
04/14/2025
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