MEDICARE: DR. CORT CURTIS PH.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	103TC0700X	Clinical Psychologist	PSY12900	CA

General Provider Information

NPI Number	:	1982809794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CORT CURTIS PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 7837
Second Line	:
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92607-7837
Country	:	US
Telephone Number	:	877-372-8784
Fax Number	:

Provider Business Practice Location Address
First Line	:	27601 FORBES RD
Second Line	:	SUITE 49
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-1201
Country	:	US
Telephone Number	:	877-372-8784
Fax Number	:

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

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	02/14/2011

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