Provider Demographics
NPI:1326258898
Name:DURAN, MARGI (LAC)
Entity Type:Individual
Prefix:
First Name:MARGI
Middle Name:
Last Name:DURAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4458 MARYLAND ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-3901
Mailing Address - Country:US
Mailing Address - Phone:619-807-4737
Mailing Address - Fax:619-260-9006
Practice Address - Street 1:4458 MARYLAND ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-3901
Practice Address - Country:US
Practice Address - Phone:619-807-4737
Practice Address - Fax:619-260-9006
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8077171100000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine