Provider Demographics
NPI:1346313939
Name:KURIHARA, RUSSELL A (MD)
Entity Type:Individual
Prefix:
First Name:RUSSELL
Middle Name:A
Last Name:KURIHARA
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 1:23388 MULHOLLAND DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2733
Mailing Address - Country:US
Mailing Address - Phone:818-855-6270
Mailing Address - Fax:818-295-3395
Practice Address - Street 1:23388 MULHOLLAND DR
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2733
Practice Address - Country:US
Practice Address - Phone:818-556-2700
Practice Address - Fax:818-295-3395
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG18697207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A40396Medicare UPIN
CAWG18697KMedicare ID - Type Unspecified
CAWG18697HMedicare ID - Type Unspecified
CAWG18697IMedicare ID - Type Unspecified
CAWG18697JMedicare ID - Type Unspecified
CAWG18697GMedicare ID - Type Unspecified