MEDICARE: JOSEPH ANTHONY DUARTE PT

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
1	225100000X	Physical Therapist	PT 21226	CA

General Provider Information

NPI Number	:	1427176445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH ANTHONY DUARTE PT

Provider Business Mailing Address
First Line	:	2741 ELYSSEE ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-3441
Country	:	US
Telephone Number	:	619-306-0352
Fax Number	:

Provider Business Practice Location Address
First Line	:	2741 ELYSSEE ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-3441
Country	:	US
Telephone Number	:	619-306-0352
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	07/08/2007

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