Provider Demographics
NPI:1083715114
Name:KURITSKY, LLOYD STUART (DO)
Entity Type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:STUART
Last Name:KURITSKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 261699
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92196-1699
Mailing Address - Country:US
Mailing Address - Phone:619-589-8626
Mailing Address - Fax:619-589-8864
Practice Address - Street 1:8851 CENTER DR
Practice Address - Street 2:SUITE 408
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3017
Practice Address - Country:US
Practice Address - Phone:619-589-8626
Practice Address - Fax:619-589-8864
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5956207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD76000Medicare UPIN