MEDICARE: TARA DURDEN MS, RDN

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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1730795410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA DURDEN MS, RDN

Provider Business Mailing Address
First Line	:	5904 WARNER AVE # 409
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-4670
Country	:	US
Telephone Number	:	562-476-9017
Fax Number	:

Provider Business Practice Location Address
First Line	:	5904 WARNER AVE UNIT 409
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-4670
Country	:	US
Telephone Number	:	562-476-9017
Fax Number	:

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

Provider Enumeration Date	:	09/18/2020
Last Update Date	:	05/22/2025

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