Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | C34712 | CA |
NPI | 1104962943 |
---|---|
Provider Name | Gilbert Duritz |
First Address | Berkeley, CA 94705-2424 |
Second Address | Berkeley, CA 94705-2424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 08/07/2007 |