Provider Demographics
NPI:1477279248
Name:DURAN, JUAN DANIEL
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:DANIEL
Last Name:DURAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 POTRERO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1430
Mailing Address - Country:US
Mailing Address - Phone:415-490-6886
Mailing Address - Fax:
Practice Address - Street 1:440 POTRERO AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1430
Practice Address - Country:US
Practice Address - Phone:415-490-6886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist