Provider Demographics
NPI:1053617316
Name:DURU, VITUS
Entity type:Individual
Prefix:
First Name:VITUS
Middle Name:
Last Name:DURU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17610 BELLFLOWER BLVD
Mailing Address - Street 2:A211
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-8000
Mailing Address - Country:US
Mailing Address - Phone:323-449-0606
Mailing Address - Fax:
Practice Address - Street 1:17610 BELLFLOWER BLVD
Practice Address - Street 2:A211
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-8000
Practice Address - Country:US
Practice Address - Phone:323-449-0606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-03
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant