Provider Demographics
NPI:1003244559
Name:CATALINO D DUREZA, MD INC
Entity Type:Organization
Organization Name:CATALINO D DUREZA, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CATALINO
Authorized Official - Middle Name:
Authorized Official - Last Name:DUREZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-343-9686
Mailing Address - Street 1:5339 N FRESNO ST
Mailing Address - Street 2:SUITE# 103
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-6851
Mailing Address - Country:US
Mailing Address - Phone:559-554-2145
Mailing Address - Fax:
Practice Address - Street 1:5339 N FRESNO ST
Practice Address - Street 2:SUITE# 103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-6851
Practice Address - Country:US
Practice Address - Phone:559-554-2145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-21
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A66607Medicaid