Provider Demographics
NPI:1326314816
Name:DELUCA, DARROW DEBS (MD)
Entity Type:Individual
Prefix:
First Name:DARROW
Middle Name:DEBS
Last Name:DELUCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 52ND STREET, ROOM 201
Mailing Address - Street 2:PEDIATRIC MULTISPECIALTY MEDICAL GROUP
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1809
Mailing Address - Country:US
Mailing Address - Phone:510-428-8399
Mailing Address - Fax:
Practice Address - Street 1:747 52ND STREET, ROOM 201
Practice Address - Street 2:PEDIATRIC MULTISPECIALTY MEDICAL GROUP
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1809
Practice Address - Country:US
Practice Address - Phone:510-428-8339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125153208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics