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NPI Code Detail

MEDICARE: DR. WILBURN DUROUSSEAU M.D.

MEDICARE:  DR. WILBURN  DUROUSSEAU  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology PhysicianG9498CA

General Provider Information

NPI Number : 1134256696
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILBURN DUROUSSEAU M.D.
Provider Business Mailing Address
First Line : 3660 E IMPERIAL HWY
Second Line :
City : LYNWOOD
State : CA
Zip : 90262-2653
Country : US
Telephone Number : 310-631-9988
Fax Number :
Provider Business Practice Location Address
First Line : 3660 E IMPERIAL HWY
Second Line :
City : LYNWOOD
State : CA
Zip : 90262-2653
Country : US
Telephone Number : 310-631-9988
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 03/07/2023

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Directions to “ DR. WILBURN DUROUSSEAU M.D.” Practice Location

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