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NPI Code Detail

MEDICARE: DR. ELIZABETH A DURKIN M.D.

MEDICARE: DR. ELIZABETH A DURKIN 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
1207Q00000XFamily Medicine PhysicianMD069328LPA
2207Q00000XFamily Medicine PhysicianC132628CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1H140550OTHERMEDICARE PROVDER NUMBER

General Provider Information

NPI Number : 1316937261
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELIZABETH A DURKIN M.D.
Provider Business Mailing Address
First Line : 5055 BUSINESS CENTER DR
Second Line : SUITE 108 BOX 422
City : FAIRFIELD
State : CA
Zip : 94534-1643
Country : US
Telephone Number : 858-205-8169
Fax Number :
Provider Business Practice Location Address
First Line : 414 S JEFFERSON ST
Second Line :
City : NAPA
State : CA
Zip : 94559-4515
Country : US
Telephone Number : 858-205-8169
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 02/11/2022

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