Individual
MR. ANTHONY DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2970 MARKET ST, SAN DIEGO, CA 92102-3241
(619) 236-9492
Mailing address
4660 EL CAJON BLVD STE 210, SAN DIEGO, CA 92115-4466
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F2000430
DRIVERS LICENSE
—
Enumeration date
11/30/2017
Last updated
02/20/2020
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