Provider Demographics
NPI:1730675315
Name:DUGA, KERTIA
Entity type:Individual
Prefix:DR
First Name:KERTIA
Middle Name:
Last Name:DUGA
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 1:9401 CRENSHAW BLVD APT 2
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-2992
Mailing Address - Country:US
Mailing Address - Phone:561-859-4986
Mailing Address - Fax:
Practice Address - Street 1:9401 CRENSHAW BLVD APT 2
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90305-2992
Practice Address - Country:US
Practice Address - Phone:561-859-4986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND915175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath