Organization Active NPI

Marvin I Porton O.D., Inc.

  • Optometrist
  • Burbank, CA
National Provider Identifier
1376654061
Registry record updated Dec 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
117 Issued in CA
Legal business name
MARVIN I PORTON O.D., INC.
Practice address
804 S Victory Blvd
Suite a
Burbank, CA 91502-2427
Phone
(818) 843-3544
Fax
(818) 845-0065
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Marvin Isaac Porton, O.D.
Title
Owner
Phone
(626) 806-5071

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 117 CA Primary

Addresses

Primary practice location

804 S Victory Blvd
Suite a
Burbank, CA 91502-2427

Mailing address

804 S Victory Blvd
Suite a
Burbank, CA 91502-2427
Phone (808) 843-3544

National Provider Directory

National Provider Directory

Locations

804 S Victory Blvd
Ste A
Burbank, CA 91502
Phone (818) 843-3544

804 S Victory Blvd
Burbank, CA 91502
Phone (818) 842-4747

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261353600000",
    "number": "1376654061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 S VICTORY BLVD",
            "address_2": "SUITE A",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915022427",
            "telephone_number": "808-843-3544",
            "fax_number": "808-845-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 S VICTORY BLVD",
            "address_2": "SUITE A",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915022427",
            "telephone_number": "818-843-3544",
            "fax_number": "818-845-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARVIN I PORTON O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-12-21",
        "status": "A",
        "authorized_official_last_name": "PORTON",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "ISAAC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-806-5071",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.