Individual
BRADLEY S KURGIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
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
20A5517
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002A55170
BLUE SHIELD
CA
Enumeration date
06/21/2006
Last updated
08/30/2022
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