Healthcare Provider Details

I. General information

NPI: 1871648840
Provider Name (Legal Business Name): CATALINO DOMINIC DUREZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 10/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5339 N FRESNO ST SUITE#103
FRESNO CA
93710-6851
US

IV. Provider business mailing address

5339 N FRESNO ST SUITE#103
FRESNO CA
93710-6851
US

V. Phone/Fax

Practice location:
  • Phone: 559-554-2145
  • Fax: 760-262-3946
Mailing address:
  • Phone: 559-554-2145
  • Fax: 760-262-3946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberA66607
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: