MEDICARE: DR. CHRISTINE V CURTIS M.D.

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	2080A0000X	Pediatric Adolescent Medicine Physician	G55808	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G55808	OTHER	CA	LICENSE

General Provider Information

NPI Number	:	1841261633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE V CURTIS M.D.

Provider Business Mailing Address
First Line	:	400 S SEPULVEDA BLVD
Second Line	:	SUITE 210
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-6814
Country	:	US
Telephone Number	:	310-374-5568
Fax Number	:	310-318-3550

Provider Business Practice Location Address
First Line	:	400 S SEPULVEDA BLVD
Second Line	:	SUITE 210
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-6814
Country	:	US
Telephone Number	:	310-374-5568
Fax Number	:	310-318-3550

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

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	07/08/2007

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