Healthcare Provider Details

I. General information

NPI: 1497773519
Provider Name (Legal Business Name): DAVID A DUARTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 S GRAND AVE STE 300
LOS ANGELES CA
90015-3075
US

IV. Provider business mailing address

14071 PEYTON DR UNIT 2023
CHINO HILLS CA
91709-7189
US

V. Phone/Fax

Practice location:
  • Phone: 562-413-8824
  • Fax: 909-680-3197
Mailing address:
  • Phone: 562-413-8824
  • Fax: 909-680-3197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberG60225
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG60225
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: