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General NPI Number Information
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NPI Number | 1629016894
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Entity Type | Individual
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Provider Name | MICHAEL J GUREVITCH M.D
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 06/26/2020
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Provider Practice Location Address
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Address Line | 39 CONGRESS ST SUITE 201
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City | PASADENA
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State | CA
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Zip | 91105-3024
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Country | US
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Telephone | 626-486-0187
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Fax |
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Provider Business Mailing Address
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Address Line | 10 CONGRESS ST STE 155
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City | PASADENA
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State | CA
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Zip | 91105-3045
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Country | US
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Telephone | 626-486-0181
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | G50403
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License Number State | CA
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