Mary Beth Durbin, DO
Individual provider Active NPI Family Medicine Physician · Beale Afb, CA
NPI 1790796522 · NPPES record last updated Mar 1, 2017
Key facts
- NPI
- 1790796522
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 1743 (ME)
- Practice address
- 15301 Warren Shingle Rd
Beale Afb, CA 95903-1907 - Phone
- (530) 634-4750
- Fax
- (530) 634-4763
- NPI assigned
- Aug 10, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160727000930 | CA | Order and Referring Only - Family Practice |
0749284495 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1743 | ME | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1743 | ME | Yes |
Addresses
Primary practice location
15301 Warren Shingle Rd
Beale Afb, CA 95903-1907
Mailing address
15301 Warren Shingle Rd
Beale Afb, CA 95903-1907
Phone (530) 634-4750
Other providers in Beale Afb, CA
- Jeffrey G Clayton
- James Clement
- Justine Cox
- Prince A Denson V
- Shelbi Duncan
- Tammy Christine Dyer
- Tony Joseph Eid
- James Thomas Feldhausen
- Caesar Fernando Flores
- Nathaniel Dean Ford
All providers in Beale Afb, CA · Family Medicine 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 1, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.