Michael John Durfee, M.D.
Individual provider Active NPI Child & Adolescent Psychiatry Physician · La Canada, CA
NPI 1700108263 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1700108263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Child & Adolescent Psychiatry Physician 2084P0804X
- License
- G16772 (CA)
- Practice address
- 210 Starlight Crest Dr
La Canada, CA 91011-2837 - Phone
- (818) 952-2053
- Fax
- (818) 952-2976
- NPI assigned
- Feb 24, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G16772 | CA | MD | Child & Adolescent Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | G16772 | CA | Yes |
Addresses
Primary practice location
210 Starlight Crest Dr
La Canada, CA 91011-2837
Mailing address
210 Starlight Crest Dr
La Canada, CA 91011-2837
Phone (818) 952-2053
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All providers in La Canada, CA · Child & Adolescent Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.