Provider Demographics
NPI:1811063985
Name:DUARTE UNIFIED SCHOOL DISTRICT
Entity type:Organization
Organization Name:DUARTE UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR, HEALTH SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:626-599-5222
Mailing Address - Street 1:1620 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-2534
Mailing Address - Country:US
Mailing Address - Phone:626-599-5222
Mailing Address - Fax:626-599-5274
Practice Address - Street 1:1212 KELLWILL WAY
Practice Address - Street 2:
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-3322
Practice Address - Country:US
Practice Address - Phone:626-599-5222
Practice Address - Fax:626-599-5274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS1964469Medicaid