Active NPI
David Gilles Dufour, PA
- Physician Assistant
- Encino, CA
National Provider Identifier
1720198385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA12099
- Practice address
- 16101 Ventura Blvd
Suite 340
Encino, CA 91436-2500 - Phone
- (818) 788-7500
- Fax
- (818) 380-9245
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA12099 | CA | Primary |
Addresses
Primary practice location
16101 Ventura Blvd
Suite 340
Encino, CA 91436-2500
Mailing address
PO Box 77790
Corona, CA 92877-0126
Phone (800) 626-2468
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA12099 | Other | CA | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361923200000",
"number": "1720198385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 77790",
"city": "CORONA",
"state": "CA",
"postal_code": "928770126",
"telephone_number": "800-626-2468",
"fax_number": "951-272-9924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16101 VENTURA BLVD",
"address_2": "SUITE 340",
"city": "ENCINO",
"state": "CA",
"postal_code": "914362500",
"telephone_number": "818-788-7500",
"fax_number": "818-380-9245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUFOUR",
"first_name": "DAVID",
"middle_name": "GILLES",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2013-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA12099",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "PA12099",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.