Individual
KATHRYN RACHEL PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6926 BROCKTON AVE, RIVERSIDE, CA 92506-3800
(616) 826-9762
Mailing address
6926 BROCKTON AVE, RIVERSIDE, CA 92506-3800
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
57353
CA
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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