Healthcare Provider Details

I. General information

NPI: 1114438413
Provider Name (Legal Business Name): KURE NETWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2017
Last Update Date: 10/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2160 W GRANT LINE RD STE 120
TRACY CA
95377-7331
US

IV. Provider business mailing address

5424 SUNOL BLVD STE 10-155
PLEASANTON CA
94566-7705
US

V. Phone/Fax

Practice location:
  • Phone: 209-836-5680
  • Fax:
Mailing address:
  • Phone: 415-935-5196
  • Fax: 415-534-2409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY HORNER
Title or Position: OWNER
Credential: M.D.
Phone: 925-984-4734