1093931024 NPI number — FRANCISCO MANUEL DURAN JR. DDS

Table of content: FRANCISCO MANUEL DURAN JR. DDS (NPI 1093931024)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093931024 NPI number — FRANCISCO MANUEL DURAN JR. DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DURAN
Provider First Name:
FRANCISCO
Provider Middle Name:
MANUEL
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DURAN
Provider Other First Name:
FRANK
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1093931024
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2397 FLETCHER PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL CAJON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92020-2134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-461-8080
Provider Business Mailing Address Fax Number:
619-461-8082

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2397 FLETCHER PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL CAJON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92020-2134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-461-8080
Provider Business Practice Location Address Fax Number:
619-461-8082
Provider Enumeration Date:
04/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  39787 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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