MEDICARE: DR. HAROLD JOHANNES DUARTE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	A186518	CA
2	207RG0100X	Gastroenterology Physician	35.144289	OH

General Provider Information

NPI Number	:	1508326182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAROLD JOHANNES DUARTE MD

Provider Business Mailing Address
First Line	:	11234 ANDERSON ST # MC1503A
Second Line	:
City	:	LOMA LINDA
State	:	CA
Zip	:	92350-1716
Country	:	US
Telephone Number	:	909-558-5512
Fax Number	:	909-558-0490

Provider Business Practice Location Address
First Line	:	11234 ANDERSON ST # MC1503A
Second Line	:
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-2804
Country	:	US
Telephone Number	:	909-558-5512
Fax Number	:	909-558-0490

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2019
Last Update Date	:	06/08/2026

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