DR. CALVIN JOSEPH DUFFAUT III (NPI# 1497056154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497056154 |
| Entity Type | Individual |
| Full Name | DR. CALVIN JOSEPH DUFFAUT III |
| Credential | M.D. |
| Practice Address |
1920 Colorado Ave Santa Monica CA 90404-3414 |
| Mailing Address |
5767 W Century Blvd Suite 400 Los Angeles CA 90045-5631 |
| Practice Telephone | 3103194700 |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2019-11-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
A114487 | CA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | A114487 | CA | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | A114487 | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1250 16th St Ste 2100, Santa Monica, CA 904041249 | 3103191234 | 4242596560 |
| 100 Ucla Medical Plz Ste 100, Los Angeles, CA 900247000 | 3103191234 | 4242596560 |
| Street Address |
1920 COLORADO AVE |
| City | SANTA MONICA |
| State | CA |
| Zip Code | 90404-3414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275591802 | Uc Regents Ucla Family Health Center | Family Medicine | 1920 Colorado Ave, Santa Monica, CA 90404-3414 | 2006-05-03 |
| 1396364147 | Fernando Jose Avila-garibay | Student in an Organized Health Care Education/Training Program | 1920 Colorado Ave, Santa Monica, CA 90404-3414 | 2020-04-13 |
| 1528694593 | Pinting Chen | Student in an Organized Health Care Education/Training Program | 1920 Colorado Ave, Santa Monica, CA 90404-3414 | 2020-03-20 |
| 1366905283 | Michelle Okoreeh | Student in an Organized Health Care Education/Training Program | 1920 Colorado Ave, Santa Monica, CA 90404-3414 | 2019-04-08 |
| 1245792712 | Ann Marie Hernandez | Student in an Organized Health Care Education/Training Program | 1920 Colorado Ave, Santa Monica, CA 90404-3414 | 2019-04-03 |
| 1033670138 | Olivia Taeko Ishibashi | Student in an Organized Health Care Education/Training Program | 1920 Colorado Ave, Santa Monica, CA 90404-3414 | 2019-03-29 |
| 1194286047 | Colleen O'neil-tennant | Student in an Organized Health Care Education/Training Program | 1920 Colorado Ave, Santa Monica, CA 90404-3414 | 2019-03-25 |
| 1104386069 | Spencer Mccaffrey | Student in an Organized Health Care Education/Training Program | 1920 Colorado Ave, Santa Monica, CA 90404-3414 | 2019-03-25 |
| 1437618469 | Jolie Portanova Cooperman | Student in an Organized Health Care Education/Training Program | 1920 Colorado Ave, Santa Monica, CA 90404-3414 | 2019-03-19 |
| 1649739764 | Nelson Boland | Student in an Organized Health Care Education/Training Program | 1920 Colorado Ave, Santa Monica, CA 90404-3414 | 2019-03-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306453352 | Jasmine Burton | Physical Therapist | 1714 17th Street, Santa Monica, CA 90404 | 2020-09-24 |
| 1003431685 | Cintia Haydee Ctibor | Behavior Technician | 1869 9th Street, Santa Monica, CA 90404 | 2020-06-10 |
| 1073137261 | Sydney Kristine Valerio | Counselor | 1869 9th St, Santa Monica, CA 90404 | 2020-06-03 |
| 1710507082 | James Gilbert Cunningham | Marriage & Family Therapist | 1708 Olympic Blvd, Santa Monica, CA 90404 | 2020-04-16 |
| 1841763687 | Crystal Monique Mckinley X | Counselor | 1865 9th St, Santa Monica, CA 90404 | 2019-01-04 |
| 1952872749 | Cesar O Munoz | Licensed Vocational Nurse | 1865 9th St., Santa Monica, CA 90404 | 2018-12-06 |
| 1023596574 | Joseph J Pinzone Md Inc | Internal Medicine | 2001 Santa Monica Blvd Ste 1190, Santa Monica, CA 90404 | 2018-08-06 |
| 1548763535 | Alan Rubenstein Dds Inc | Dentist | 1260 15th St., #703, Santa Monica, CA 90404 | 2018-03-15 |
| 1669993382 | Aaron Wilson | Counselor | 1453 16th Street, Santa Monica, CA 90404 | 2017-07-03 |
| 1922472471 | Chianni Lin | Acupuncturist | 2222 Santa Monica Blvd, Ste. 105, Santa Monica, CA 90404 | 2015-11-20 |
| Find all providers in zip 90404 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932423225 | Douglas Li | Pediatrics | 1260 15th St Ste 1024, Santa Monica, CA 90404-1145 | 2010-03-16 |
| 1457582934 | Shahrouz Daniel Ganjian | Pediatrics | 2021 Santa Monica Blvd Ste 245e, Santa Monica, CA 90404-2132 | 2009-08-02 |
| 1427285816 | Jayme E. Heath | Pediatrics | 2825 Santa Monica Blvd Ste 104, Santa Monica, CA 90404-2429 | 2009-06-12 |
| 1891919205 | Carla V. Tardio | Pediatrics | 1450 10th St., Suite 304, Santa Monica, CA 90401-2838 | 2007-04-13 |
| 1346369311 | Kristin Brett Pelinka | Pediatrics | 2216 Santa Monica Blvd Ste 204, Santa Monica, CA 90404-2317 | 2007-03-28 |
| 1376681445 | Richard Frederic Levy | Pediatrics | 934 21st St, Santa Monica, CA 90403-3433 | 2007-02-02 |
| 1548354129 | Tenth Street Pediatric Medical Group, Inc. | Pediatrics | 1450 10th Street, Suite 304, Santa Monica, CA 90401-2838 | 2006-10-03 |
| 1316050743 | Rebecca Dimundo | Pediatrics | 2210 Santa Monica Blvd Ste 0, Santa Monica, CA 90404-2313 | 2006-08-17 |
| 1639180623 | Aziz Nourmand | Pediatrics | 2001 Santa Monica Blvd Ste 865w, Santa Monica, CA 90404-2128 | 2006-08-11 |
| 1316982713 | Maria Elena Lara | Pediatrics | 1776 Main Street, Rand, Santa Monica, CA 90407 | 2006-06-19 |
| Find all providers in SANTA MONICA | ||||
| City | SANTA MONICA |
| Zip Code | 90404 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.