=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871392852
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DUANE EVERETT FLANIGAN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/11/2025
-----------------------------------------------------
Last Update Date | 03/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 560 COHASSET RD STE 185
-----------------------------------------------------
City | CHICO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95926-2460
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-353-0408
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1133
-----------------------------------------------------
City | LOS MOLINOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 96055-1133
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-250-9522
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 172V00000X
-----------------------------------------------------
Taxonomy Name | Community Health Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------