MEDICARE: DR. JAN W DUNCAN MD

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	207XS0117X	Orthopaedic Surgery of the Spine Physician	C38275	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C38275	OTHER	CA	CALIFORNIA STATE LICENSE

General Provider Information

NPI Number	:	1821109083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAN W DUNCAN MD

Provider Business Mailing Address
First Line	:	711 W COLLEGE ST
Second Line	:	#625
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-1163
Country	:	US
Telephone Number	:	323-267-0222
Fax Number	:	213-621-4440

Provider Business Practice Location Address
First Line	:	711 W COLLEGE ST
Second Line	:	#625
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-1163
Country	:	US
Telephone Number	:	323-267-0222
Fax Number	:	213-621-4440

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	03/22/2010

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