Individual
JON STEPHEN PORTNOFF
Active
Individual
JON STEPHEN PORTNOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A43219
CA
207RI0011X
Interventional Cardiology Physician
A43219
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A432190
BLUE SHIELD OF CALIFORNIA
CA
05
—
00A432190
—
CA
01
—
060020995
RAILROAD MEDICARE
CA
01
—
ZZZ00872Z
MEDICARE PTAN
CA
Enumeration date
07/13/2005
Last updated
10/25/2012
Update your record
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