Provider Demographics
NPI:1760427926
Name:DURHAM, BRITT A (MD)
Entity Type:Individual
Prefix:
First Name:BRITT
Middle Name:A
Last Name:DURHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BRITT
Other - Middle Name:AUSTIN
Other - Last Name:DURHAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 39159
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90239
Mailing Address - Country:US
Mailing Address - Phone:562-809-3576
Mailing Address - Fax:562-468-0347
Practice Address - Street 1:11500 BROOKSHIRE AVENUE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241
Practice Address - Country:US
Practice Address - Phone:562-904-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG61109207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G611090Medicaid
F08765Medicare UPIN
CAWG61109GMedicare PIN