Provider Demographics
NPI:1114066974
Name:DUNCAN, MAX BARNETT (DO)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:BARNETT
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 DISTEL CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:707-521-7788
Mailing Address - Fax:707-523-1309
Practice Address - Street 1:3883 AIRWAY DR
Practice Address - Street 2:SUITE 201
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-1670
Practice Address - Country:US
Practice Address - Phone:707-521-7755
Practice Address - Fax:707-523-1309
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1282692084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A5164OtherSTATE MEDICAL LICENSE
OR120389Medicare ID - Type Unspecified
OR022582Medicaid