Provider Demographics
NPI:1902875982
Name:DUBAN, MARILYN LIMFUECO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:LIMFUECO
Last Name:DUBAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2757
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92859-0757
Mailing Address - Country:US
Mailing Address - Phone:714-973-2650
Mailing Address - Fax:714-973-2655
Practice Address - Street 1:15910 VENTURA BLVD
Practice Address - Street 2:SUITE 1502
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2802
Practice Address - Country:US
Practice Address - Phone:818-728-9877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76592207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A765920Medicaid
CAH92009Medicare UPIN
CA00A765920Medicaid