Healthcare Provider Details

I. General information

NPI: 1104858620
Provider Name (Legal Business Name): GRAHAM R. HURVITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2936 DE LA VINA ST FIRST FLOOR
SANTA BARBARA CA
93105-3354
US

IV. Provider business mailing address

2936 DE LA VINA ST FIRST FLOOR
SANTA BARBARA CA
93105-3354
US

V. Phone/Fax

Practice location:
  • Phone: 805-963-2729
  • Fax: 805-963-3818
Mailing address:
  • Phone: 805-963-2729
  • Fax: 805-963-3818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA68405
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA68405
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: