MEDICARE: DR. MICHAEL Z KURTZ 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	207QS0010X	Sports Medicine (Family Medicine) Physician	20A4525	CA

General Provider Information

NPI Number	:	1194814020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL Z KURTZ D.O.

Provider Business Mailing Address
First Line	:	12495 VALLEY VIEW ST
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-2032
Country	:	US
Telephone Number	:	714-897-9355
Fax Number	:

Provider Business Practice Location Address
First Line	:	12495 VALLEY VIEW ST
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-2032
Country	:	US
Telephone Number	:	714-897-9355
Fax Number	:	714-897-5117

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	02/08/2022

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