Healthcare Provider Details

I. General information

NPI: 1720037633
Provider Name (Legal Business Name): BENEDIKT KURZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 12/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20101 LAKE CHABOT RD
CASTRO VALLEY CA
94546-5305
US

IV. Provider business mailing address

3687 MT DIABLO BLVD #200
LAFAYETTE CA
94549-3717
US

V. Phone/Fax

Practice location:
  • Phone: 510-886-3400
  • Fax:
Mailing address:
  • Phone: 510-204-6660
  • Fax: 925-299-6849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA81945
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: