Provider Demographics
NPI:1649581851
Name:RICH, PORCHIA RENEE (MD)
Entity Type:Individual
Prefix:
First Name:PORCHIA
Middle Name:RENEE
Last Name:RICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PORCHIA
Other - Middle Name:RICH
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9500 GILMAN DRIVE MAIL CODE # 0811
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92093-0001
Mailing Address - Country:US
Mailing Address - Phone:858-534-9540
Mailing Address - Fax:
Practice Address - Street 1:9500 GILMAN DRIVE MAIL CODE # 0811
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-0001
Practice Address - Country:US
Practice Address - Phone:858-534-9540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1315992083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine