Provider Demographics
NPI:1831199728
Name:DARNELL, DUANE RAY (DO)
Entity type:Individual
Prefix:DR
First Name:DUANE
Middle Name:RAY
Last Name:DARNELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27994 BRADLEY RD
Mailing Address - Street 2:STE F
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586
Mailing Address - Country:US
Mailing Address - Phone:951-246-1366
Mailing Address - Fax:951-246-1466
Practice Address - Street 1:27994 BRADLEY RD
Practice Address - Street 2:STE F
Practice Address - City:SUN CITY
Practice Address - State:CA
Practice Address - Zip Code:92586
Practice Address - Country:US
Practice Address - Phone:951-246-1366
Practice Address - Fax:951-246-1466
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A4863207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB45730Medicare UPIN