Individual
JON STEPHEN PORTNOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
260 HOSPITAL DR, SUITE 207, UKIAH, CA 95482-4533
(707) 463-2400
(707) 463-3520
Mailing address
PO BOX 2739, UKIAH, CA 95482-2739
(707) 463-8000
(707) 462-1111
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
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us