Michael Port, MD is a
Pain Medicine - Pain Medicine physician based in Marina Del Rey, California. Michael Port is licensed to practice in California (license number G77719) and his current practice location is 13160 Mindanao Way, Suite #300, Marina Del Rey, California. He can be reached at his office (for appointments etc.) via phone at
(310) 854-3800.
NPI number for Michael Port is 1710005731 and his current mailing address is 125 Eucalyptus Dr, El Segundo, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1710005731.
Physician's Profile
| Full Name | Michael Port |
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| Gender | Male |
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| Speciality | Pain Medicine - Pain Medicine |
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| Location | 13160 Mindanao Way, Marina Del Rey, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1710005731
- Provider Enumeration Date: 03/27/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Michael Port such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1710005731 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207L00000X | Anesthesiology | G77719 (California) | Primary |
| 208VP0000X | Pain Medicine - Pain Medicine | G77719 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Michael Port is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Michael Port, MD
125 Eucalyptus Dr,
El Segundo, CA 90245-3839
Ph: () - | Michael Port, MD
13160 Mindanao Way, Suite #300,
Marina Del Rey, CA 90292-6358
Ph: (310) 854-3800 |
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