Individual
MARY A PORCIONCULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21 LOCUST ST, RENO, NV 89502-1316
(775) 982-5270
(775) 982-5288
Mailing address
780 KUENZLI ST, SUITE 202, RENO, NV 89502-0845
(775) 982-4590
(775) 982-5496
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9992
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11041511
CAQH
—
05
—
1861517120
—
NV
Enumeration date
03/19/2007
Last updated
12/04/2009
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