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NPI Code Detail

MEDICARE: MS. DEBRA PORTER

MEDICARE: MS. DEBRA PORTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1033244975
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBRA PORTER
Provider Business Mailing Address
First Line : 7120 FRANKLIN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90046-3002
Country : US
Telephone Number : 562-497-1301
Fax Number : 310-868-5398
Provider Business Practice Location Address
First Line : 7120 FRANKLIN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90046-3002
Country : US
Telephone Number : 562-497-1301
Fax Number : 310-868-5398
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 06/27/2023

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