Provider Demographics
NPI:1891453593
Name:DURRANT, KOLIN (DACM, LAC)
Entity Type:Individual
Prefix:DR
First Name:KOLIN
Middle Name:
Last Name:DURRANT
Suffix:
Gender:M
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 GOLDEN GATE DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-1138
Mailing Address - Country:US
Mailing Address - Phone:619-550-6461
Mailing Address - Fax:
Practice Address - Street 1:4501 MISSION BAY DR STE 2D
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-4925
Practice Address - Country:US
Practice Address - Phone:858-333-7907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist