Edward Portnoy MD, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G30207 Issued in CA

Legal business name

EDWARD PORTNOY MD, INC

Practice address

1220 La Venta Rd
100
Westlake Village, CA 91361-3703

Phone

(805) 497-9272

Fax

(805) 497-7082

NPI assigned

Sep 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Edward Barry Portnoy, MD

Title

President

Phone

(805) 497-9272

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871695601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 LA VENTA RD",
            "address_2": "100",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913613703",
            "telephone_number": "805-497-9272",
            "fax_number": "805-497-7082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 LA VENTA RD",
            "address_2": "100",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913613703",
            "telephone_number": "805-497-9272",
            "fax_number": "805-497-7082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD PORTNOY MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2020-08-22",
        "certification_date": "2020-05-28",
        "status": "A",
        "authorized_official_last_name": "PORTNOY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "BARRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-497-9272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G30207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.