Healthcare Provider Details

I. General information

NPI: 1396927877
Provider Name (Legal Business Name): MICHAEL ALAN HURWITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2869 GOLF VILLA WAY
CAMARILLO CA
93010-7490
US

IV. Provider business mailing address

2869 GOLF VILLA WAY
CAMARILLO CA
93010-7490
US

V. Phone/Fax

Practice location:
  • Phone: 805-485-5070
  • Fax: 805-485-3628
Mailing address:
  • Phone: 805-485-5070
  • Fax: 805-485-3628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC50227
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: