Individual
MICHAEL PORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13160 MINDANAO WAY, SUITE #300, MARINA DEL REY, CA 90292-6358
(310) 854-3800
(310) 854-3820
Mailing address
125 EUCALYPTUS DR, EL SEGUNDO, CA 90245-3839
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
G77719
CA
208VP0000X
Pain Medicine Physician
Primary
G77719
CA
Other
Enumeration date
03/27/2007
Last updated
09/11/2025
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