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General NPI Number Information
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NPI Number | 1629581681
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Entity Type | Organization
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Legal Business Name | PAMELA L KURTZHALS MD FACS A MEDICAL CORPORATION
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Dates
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Enumeration Date | 11/13/2017
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Last Update Date | 11/28/2017
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Provider Practice Location Address
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Address Line | 3075 HEALTH CENTER DR STE 102
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City | SAN DIEGO
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State | CA
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Zip | 92123-2773
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Country | US
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Telephone | 619-354-2777
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Fax | 619-342-9411
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Provider Business Mailing Address
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Address Line | 3075 HEALTH CENTER DR STE 102
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City | SAN DIEGO
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State | CA
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Zip | 92123-2773
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Country | US
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Telephone | 619-354-2777
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Fax | 619-342-9411
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAMELA L. KURTZHALS
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Credential | M.D.
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Telephone | 619-354-2777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A75524
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License Number State | CA
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