Provider Demographics
NPI:1073684809
Name:NIELSEN, DUANE HUGH (ARRT, CRT)
Entity Type:Individual
Prefix:MR
First Name:DUANE
Middle Name:HUGH
Last Name:NIELSEN
Suffix:
Gender:M
Credentials:ARRT, CRT
Other - Prefix:
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Mailing Address - Street 1:28902 BOLEADA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-3904
Mailing Address - Country:US
Mailing Address - Phone:949-365-0822
Mailing Address - Fax:
Practice Address - Street 1:1725 W 17TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2316
Practice Address - Country:US
Practice Address - Phone:714-934-8017
Practice Address - Fax:714-834-8728
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHT 60333247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist