Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 005679 | NY |
Y | 222Z00000X | Podiatrist | 005679 | NY |
N | 111NR0200X | Radiology | 005679 | NY |
N | 213ER0200X | Radiology | 005679 | NY |
N | 213ES0131X | Foot Surgery | 005679 | NY |
NPI | 1881633485 |
---|---|
Provider Name | Dr. Carla Jean Porter-Pursnani |
First Address | Foster City, CA 94404-1678 |
Second Address | Foster City, CA 94404-1678 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 23/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00355931 | (05) | NY |
02275712 | (05) | NY |
U89365 | (02) | NY |