Healthcare Provider Details

I. General information

NPI: 1851489769
Provider Name (Legal Business Name): DEBORAH KERR MCCURDY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 10/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10833 LE CONTE AVE
LOS ANGELES CA
90095-1752
US

IV. Provider business mailing address

3835 LONGRIDGE AVE
SHERMAN OAKS CA
91423-4921
US

V. Phone/Fax

Practice location:
  • Phone: 310-206-1826
  • Fax: 310-825-9832
Mailing address:
  • Phone: 818-501-7806
  • Fax: 310-825-9832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License NumberC40905
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: