Individual
DR. MARC J POROT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
515 S VAN NESS AVE, LOS ANGELES, CA 90020-4616
(213) 493-2086
Mailing address
PO BOX 3129, TORRANCE, CA 90510-3129
(310) 792-3914
(855) 898-4055
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A42809
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A42809
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010150034
REGENCE BLUE SHIELD
ID
01
—
268236
ALTIUS OLD
ID
01
—
313072
ALTIUS
ID
01
—
74138
BLUE CROSS OLD
ID
05
—
807141500
—
ID
01
—
HB401
BLUE CROSS
ID
Enumeration date
04/25/2006
Last updated
12/03/2014
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