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General NPI Number Information
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NPI Number | 1538219613
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Entity Type | Organization
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Legal Business Name | KESTUTIS V. KURAITIS, M.D., PH.D., INC.
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 11/23/2011
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Provider Practice Location Address
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Address Line | 751 W LEGION RD SUITE 204
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City | BRAWLEY
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State | CA
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Zip | 92227-7732
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Country | US
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Telephone | 760-351-2626
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Fax | 760-351-2617
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Provider Business Mailing Address
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Address Line | PO BOX 651
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City | BRAWLEY
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State | CA
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Zip | 92227-0651
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Country | US
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Telephone | 760-351-2626
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Fax | 760-351-2617
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KESTUTIS V. KURAITIS
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Credential | M.D.
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Telephone | 760-351-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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