Healthcare Provider Details

I. General information

NPI: 1033615984
Provider Name (Legal Business Name): WILLIAM DUFFICY MD (EXPECTED 5/2018)
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2018
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 CAPITOLA RD
SANTA CRUZ CA
95062-2912
US

IV. Provider business mailing address

PO BOX 542
SANTA CRUZ CA
95061-0542
US

V. Phone/Fax

Practice location:
  • Phone: 831-427-3500
  • Fax: 831-457-2486
Mailing address:
  • Phone: 831-427-3500
  • Fax: 831-427-7785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA180816
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: