Provider Demographics
NPI:1437808797
Name:DUQUE, NORMA A
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:A
Last Name:DUQUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 POMONA BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-1717
Mailing Address - Country:US
Mailing Address - Phone:323-816-2400
Mailing Address - Fax:323-720-9953
Practice Address - Street 1:5400 POMONA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1717
Practice Address - Country:US
Practice Address - Phone:323-816-2400
Practice Address - Fax:323-720-9953
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator