Provider Demographics
NPI:1427176445
Name:DUARTE, JOSEPH ANTHONY (PT)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:DUARTE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 ELYSSEE ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-3441
Mailing Address - Country:US
Mailing Address - Phone:619-306-0352
Mailing Address - Fax:
Practice Address - Street 1:2741 ELYSSEE ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-3441
Practice Address - Country:US
Practice Address - Phone:619-306-0352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 21226225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist