Healthcare Provider Details

I. General information

NPI: 1437179595
Provider Name (Legal Business Name): MICHAEL B. HURWITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 12/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 WESTCLIFF DR STE 2
NEWPORT BEACH CA
92660-5505
US

IV. Provider business mailing address

3334 E COAST HWY STE 176
CORONA DEL MAR CA
92625-2328
US

V. Phone/Fax

Practice location:
  • Phone: 949-631-4890
  • Fax: 949-631-4008
Mailing address:
  • Phone: 949-631-4890
  • Fax: 949-631-4008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA48266
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: