Alyviah Durham, PA-C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

PA60807 Issued in CA

Practice address

2301 E Foothill Blvd
Glendora, CA 91740-4000

Phone

(626) 852-3376

NPI assigned

Feb 23, 2022

Last updated

Feb 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Dermatology Center of Pasadena, a Medical GroupGroup PAC ID 3173701497, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Comprehensive Dermatology Center of Pasadena, a Medical Group

  • Medical Specialty Clinic/Center
  • Pasadena, CA
  • NPI 1740485010
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1275289746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2363 1ST ST UNIT 25",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917505527",
            "telephone_number": "217-827-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 E FOOTHILL BLVD",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404000",
            "telephone_number": "626-852-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10470 Foothill Blvd Unit 127",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917303754",
            "country_code": "US",
            "telephone_number": "909-312-4356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "ALYVIAH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "PA60807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dean Duggan, DC
• Karen M. Dunaetz, LMFT
• Tricia Lynn Duncan-Hassel, PSY.D.
• Amanda E Duncan, PA-C
• Mariela Duran-Troncoso, LMFT
• Jenna D Duvall, OTR/L
• East Valley Emergency Medical Associates, Inc.
• East Valley Glendora Hospital LLC (Glendora Oaks Behavioral Health Hospital)
• East Valley Glendora Hospital LLC (Glendora Community Hospital)
• East Valley Hospital Medical Center

• Dermatology Physician in Glendora, CA
• Providers in Glendora, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.