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NPI Code Detail

MEDICARE: MS. MARTHA DURAN PA-C

MEDICARE: MS. MARTHA DURAN PA-C
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
1363A00000XPhysician AssistantPA 14451CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA14451OTHERCALICENSE
21036816OTHERCANCCPA

General Provider Information

NPI Number : 1528045838
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARTHA DURAN PA-C
Provider Business Mailing Address
First Line : 344 E 6TH ST
Second Line :
City : MADERA
State : CA
Zip : 93638-3631
Country : US
Telephone Number : 559-664-4000
Fax Number : 559-675-5608
Provider Business Practice Location Address
First Line : 344 E 6TH ST
Second Line :
City : MADERA
State : CA
Zip : 93638-3631
Country : US
Telephone Number : 559-664-4000
Fax Number : 559-675-5608
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 03/07/2023

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