Healthcare Provider Details

I. General information

NPI: 1811068562
Provider Name (Legal Business Name): MYRON ANTHONY DURRANT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W EL NORTE PKWY # 57
ESCONDIDO CA
92026-1960
US

IV. Provider business mailing address

306 W EL NORTE PKWY # 57
ESCONDIDO CA
92026-1960
US

V. Phone/Fax

Practice location:
  • Phone: 760-809-3018
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC20476
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: