Provider Demographics
NPI:1194814020
Name:KURTZ, MICHAEL Z (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:Z
Last Name:KURTZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12495 VALLEY VIEW ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-2032
Mailing Address - Country:US
Mailing Address - Phone:714-897-9355
Mailing Address - Fax:
Practice Address - Street 1:12495 VALLEY VIEW ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-2032
Practice Address - Country:US
Practice Address - Phone:714-897-9355
Practice Address - Fax:714-897-5117
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A4525207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW14791Medicare ID - Type Unspecified
CAA93585Medicare UPIN