MEDICARE: DAVID PORZIO M.D.

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
1	174400000X	Specialist	A76138	CA

General Provider Information

NPI Number	:	1457391740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID PORZIO M.D.

Provider Business Mailing Address
First Line	:	1730 PORT SHEFFIELD PL
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-5326
Country	:	US
Telephone Number	:	949-554-4733
Fax Number	:	949-706-5629

Provider Business Practice Location Address
First Line	:	1730 PORT SHEFFIELD PL
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-5326
Country	:	US
Telephone Number	:	949-554-4733
Fax Number	:	949-706-5629

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	04/03/2013

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