Provider Demographics
NPI:1053471318
Name:KOURA, DIVYA TIWARI (MD)
Entity Type:Individual
Prefix:DR
First Name:DIVYA
Middle Name:TIWARI
Last Name:KOURA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3855 HEALTH SCIENCES DR
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92093-0960
Mailing Address - Country:US
Mailing Address - Phone:858-822-6600
Mailing Address - Fax:
Practice Address - Street 1:3855 HEALTH SCIENCES DR
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-1013
Practice Address - Country:US
Practice Address - Phone:858-657-7000
Practice Address - Fax:858-822-6844
Is Sole Proprietor?:No
Enumeration Date:2006-12-09
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA125774207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology