Healthcare Provider Details

I. General information

NPI: 1831266048
Provider Name (Legal Business Name): PAUL SCOTT KURTIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1157 SOLANA DR
DEL MAR CA
92014-3907
US

IV. Provider business mailing address

1157 SOLANA DR
DEL MAR CA
92014-3907
US

V. Phone/Fax

Practice location:
  • Phone: 858-259-8775
  • Fax: 858-966-7774
Mailing address:
  • Phone: 858-259-8775
  • Fax: 858-966-7774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberG 73091
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: