Provider Demographics
NPI:1023300258
Name:DURAN, ELIZABETH
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:DURAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 S DE LACEY AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2048
Mailing Address - Country:US
Mailing Address - Phone:626-395-7100
Mailing Address - Fax:626-685-2126
Practice Address - Street 1:12510 VAN NUYS BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331-1338
Practice Address - Country:US
Practice Address - Phone:818-896-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner