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General NPI Number Information
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NPI Number | 1992962013
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Entity Type | Organization
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Legal Business Name | KURT R WHARTON MD, INC.
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 970 DEWING AVE SUITE 201
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City | LAFAYETTE
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State | CA
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Zip | 94549-4291
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Country | US
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Telephone | 925-962-0002
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Fax | 925-962-0003
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Provider Business Mailing Address
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Address Line | 970 DEWING AVE SUITE 201
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City | LAFAYETTE
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State | CA
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Zip | 94549-4291
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Country | US
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Telephone | 925-962-0002
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Fax | 925-962-0003
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. JENNIFER D MCGETTIGAN
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Credential |
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Telephone | 925-962-0002
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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 | G57090
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License Number State | CA
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