Organization
BRADLEY S KURGIS D O INC
Active
Organization
BRADLEY S KURGIS D O INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY S KURGIS DO (OWNER)
(805) 434-5563
Entity
Organization
Contact information
Practice address
1320 LAS TABLAS RD, SUITE B, TEMPLETON, CA 93465-9711
(805) 434-5563
(805) 434-5916
Mailing address
1320 LAS TABLAS RD, SUITE B, TEMPLETON, CA 93465-9711
(805) 434-5563
(805) 434-5916
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A55170
MEDICARE ID
CA
Enumeration date
06/08/2011
Last updated
10/26/2020
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