Healthcare Provider Details

I. General information

NPI: 1558981647
Provider Name (Legal Business Name): ETKA KURUCAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2020
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 N HARBOR BLVD STE 35000
FULLERTON CA
92835-3831
US

IV. Provider business mailing address

3600 FORBES AVE STE 140
PITTSBURGH PA
15213-3410
US

V. Phone/Fax

Practice location:
  • Phone: 805-456-6349
  • Fax:
Mailing address:
  • Phone: 412-647-6340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA208698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: