Organization
JULIE G. DUQUETTE M.D. A MEDICAL CORPORATION
Active
Organization
JULIE G. DUQUETTE M.D. A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIE GAY DUQUETTE M.D. (PRESIDENT, LABORATORY DIRECTOR)
(949) 515-3462
Entity
Organization
Contact information
Practice address
2043 WESTCLIFF DR, SUITE 302, NEWPORT BEACH, CA 92660-5537
(949) 515-3462
(949) 515-4279
Mailing address
2043 WESTCLIFF DR, SUITE 302, NEWPORT BEACH, CA 92660-5537
(949) 515-3462
(949) 515-4279
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF 11780
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D1010850
CLIA NUMBER
CA
01
—
CLF 11780
CALIFORNIA LABORATORY LIC
CA
Enumeration date
09/23/2006
Last updated
11/07/2011
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