Provider Demographics
NPI:1104858620
Name:HURVITZ, GRAHAM R (MD)
Entity Type:Individual
Prefix:DR
First Name:GRAHAM
Middle Name:R
Last Name:HURVITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2936 DE LA VINA ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3354
Mailing Address - Country:US
Mailing Address - Phone:805-963-2729
Mailing Address - Fax:805-963-3818
Practice Address - Street 1:2936 DE LA VINA ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3354
Practice Address - Country:US
Practice Address - Phone:805-963-2729
Practice Address - Fax:805-963-3818
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68405174400000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5400420001Medicare NSC
CAH24429Medicare UPIN