Provider Demographics
NPI:1669894713
Name:DUFFIN, DARCY (PA-C)
Entity type:Individual
Prefix:
First Name:DARCY
Middle Name:
Last Name:DUFFIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5521 LA JOLLA HERMOSA AVE
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-7616
Mailing Address - Country:US
Mailing Address - Phone:619-203-2032
Mailing Address - Fax:
Practice Address - Street 1:9339 GENESEE AVE STE P39
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2120
Practice Address - Country:US
Practice Address - Phone:858-545-5755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA23134363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical