Provider Demographics
NPI:1326203753
Name:DUNCAN, PAUL ALLEN (MSW)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:ALLEN
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:PAUL
Other - Middle Name:ALLEN
Other - Last Name:GILLON-FLORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:456 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-2426
Mailing Address - Country:US
Mailing Address - Phone:562-279-4504
Mailing Address - Fax:
Practice Address - Street 1:456 ELM AVE,
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-2426
Practice Address - Country:US
Practice Address - Phone:562-437-6717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA265021041C0700X
225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical