Provider Demographics
NPI:1902783004
Name:DURAN, VICTOR ALAN
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:ALAN
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 1:400 GOLD AVE SW STE 1060
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-3263
Mailing Address - Country:US
Mailing Address - Phone:305-450-9651
Mailing Address - Fax:
Practice Address - Street 1:400 GOLD AVE SW STE 1060
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3263
Practice Address - Country:US
Practice Address - Phone:305-450-9651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker