Individual
MR. ANTHONY JAY DURFEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5471 KEARNY VILLA RD, SUITE 200, SAN DIEGO, CA 92123-1151
(858) 571-0606
(858) 571-1933
Mailing address
5471 KEARNY VILLA RD, SUITE 200, SAN DIEGO, CA 92123-1151
(858) 571-0606
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA17641
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W17163
MEDICARE PTAN
—
01
—
WPA17641A
MEDICARE PROVIDER ID
—
Enumeration date
04/17/2006
Last updated
12/01/2021
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