Healthcare Provider Details

I. General information

NPI: 1700108263
Provider Name (Legal Business Name): MICHAEL JOHN DURFEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2010
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 STARLIGHT CREST DR
LA CANADA CA
91011-2837
US

IV. Provider business mailing address

210 STARLIGHT CREST DR
LA CANADA CA
91011-2837
US

V. Phone/Fax

Practice location:
  • Phone: 818-952-2053
  • Fax: 818-952-2976
Mailing address:
  • Phone: 818-952-2053
  • Fax: 818-952-2976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG16772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: