Individual
DR. DURBA DUTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3883 AIRWAY DR STE 100, SANTA ROSA, CA 95403
(707) 521-4480
(707) 521-4460
Mailing address
325 DISTEL CIRCLE, LOS ALTOS, CO 94002-1408
(707) 521-4480
(707) 521-4460
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
RHL00161349
CA
208D00000X
General Practice Physician
G87087
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3845061
CIGNA
—
01
—
G87087
STATE MEDICAL LICENSE
CA
01
—
RHL00161349
CALIFORNIA XRAY BOARD
CA
Enumeration date
07/06/2006
Last updated
03/07/2023
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