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General NPI Number Information
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NPI Number | 1043980428
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Entity Type | Individual
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Provider Name | VINCENT D. DUNCAN RADT
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Gender | Male
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 17822 BEACH BLVD STE 278
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-7180
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Country | US
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Telephone | 714-375-3795
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Fax | 714-375-3796
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Provider Business Mailing Address
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Address Line | 301 N FORD AVE APT 219
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City | FULLERTON
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State | CA
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Zip | 92832-1460
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Country | US
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Telephone | 213-999-7405
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Fax | 657-378-9271
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | R1379530320
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License Number State | CA
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