Basic Information
| Provider Information | |||||||||
| NPI: | 1881040236 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PORCADAS | ||||||||
| FirstName: | JAMIE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8810 RIO SAN DIEGO DR | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921081698 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 8810 RIO SAN DIEGO DR | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278936116 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2016 | ||||||||
| LastUpdateDate: | 08/18/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A161517 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | TRN22911 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.