Provider Demographics
NPI:1417028275
Name:DUERBECK, NORMAN BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:BRIAN
Last Name:DUERBECK
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 1:12264 EL CAMINO REAL
Mailing Address - Street 2:STE. 204
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130
Mailing Address - Country:US
Mailing Address - Phone:858-794-7700
Mailing Address - Fax:858-794-7744
Practice Address - Street 1:12264 EL CAMINO REAL
Practice Address - Street 2:STE. 204
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130
Practice Address - Country:US
Practice Address - Phone:858-794-7700
Practice Address - Fax:858-794-7744
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG47611207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G476110Medicaid
CAA92735Medicare UPIN
CA00G476110Medicaid