Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | C30614 | CA |
NPI | 1851067417 |
---|---|
Provider Name | Dr. Charles William Durnin |
First Address | Long Beach, CA 90803 |
Second Address | Long Beach, CA 90803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2021 |
Last Update Date | 23/08/2021 |