| Doctor Name: | DAMAYANTHI DURAIRAJ |
| NPI Number: | 1508829714 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 00A39805 |
| Business Practice Address: | 1574 W Base Line St Suite 107 San Bernardino, CA - 924111736 |
| Business Phone Number: | 9093861880 |
| Business Fax Number: | 9093861882 |
| Mailing Address: | 19726 Segovia Ln, YORBA LINDA |
| State: | CA |
| Postal Code: | 928862841 |
| Phone Number: | 9098817320 |
| Fax Number: | 9098817329 |
| NPI Enumeration Date: | 04/10/2006 |
| NPI Last Update Date: | 10/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 00A39805 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |