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Contact Information

JACOB S PORTER, DO
7117 BROCKTON AVE
RIVERSIDE, CA92506-2658
 Phone: 951-782-3685
 Fax: 951-784-3256
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Pediatric Emergency Medicine

207PP0204X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for JACOB S PORTER · (Male)

NPI Number 1467727081
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 03/14/2012
Last updated 04/14/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • CA License # 20A15727
  • OK License # 5426
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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