MEDICARE: TYRONE MCDUFFIE

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	225X00000X	Occupational Therapist	106361	MN

General Provider Information

NPI Number	:	1861334930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYRONE MCDUFFIE

Provider Business Mailing Address
First Line	:	25103 RYE CANYON LOOP
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-5004
Country	:	US
Telephone Number	:	612-710-2787
Fax Number	:

Provider Business Practice Location Address
First Line	:	25103 RYE CANYON LOOP
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-5004
Country	:	US
Telephone Number	:	612-710-2787
Fax Number	:

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

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	05/18/2026

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Directions to “ TYRONE MCDUFFIE ” Practice Location

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