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Individual

MR. DAVID GILLES DUFOUR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
16101 VENTURA BLVD, SUITE 340, ENCINO, CA 91436-2500
(818) 788-7500
(818) 380-9245
Mailing address
PO BOX 77790, CORONA, CA 92877-0126
(800) 626-2468
(951) 272-9924

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12099
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA12099
MEDICAL LICENSE
CA
Enumeration date
08/30/2006
Last updated
02/27/2013
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