MEDICARE: DR. HEATHER MILLER KURERA D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	20A 12214	CA
2	2084P0800X	Psychiatry Physician	02002891A	IN

General Provider Information

NPI Number	:	1144228396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEATHER MILLER KURERA D.O.

Provider Business Mailing Address
First Line	:	831 E ARROW HWY
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91767-2535
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	831 E ARROW HWY
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91767-2535
Country	:	US
Telephone Number	:	909-398-4383
Fax Number	:	909-398-0127

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	02/21/2017

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