Healthcare Provider Details

I. General information

NPI: 1801568555
Provider Name (Legal Business Name): EDWARD JOSEPH DUNCAN NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST
SAN FRANCISCO CA
94121-1563
US

IV. Provider business mailing address

4150 CLEMENT ST
SAN FRANCISCO CA
94121-1563
US

V. Phone/Fax

Practice location:
  • Phone: 415-750-2110
  • Fax: 415-750-6614
Mailing address:
  • Phone: 415-750-2110
  • Fax: 415-750-6614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95018627
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: