Healthcare Provider Details

I. General information

NPI: 1184619892
Provider Name (Legal Business Name): CURTIS CLAYTON HORTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 06/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 GENESEE AVE SHARP REES STEALY GENERAL SURGERY
SAN DIEGO CA
92123-4219
US

IV. Provider business mailing address

2020 GENESEE AVE SHARP REES STEALY GENERAL SURGERY
SAN DIEGO CA
92123-4219
US

V. Phone/Fax

Practice location:
  • Phone: 858-616-8200
  • Fax: 858-616-8258
Mailing address:
  • Phone: 858-616-8200
  • Fax: 858-616-8258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number10860
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberA82215
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: