Provider Demographics
NPI:1457663460
Name:KURIEN, THOMAS V (BPHARM)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:V
Last Name:KURIEN
Suffix:
Gender:M
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17662 IRVINE BLVD
Mailing Address - Street 2:STE 14
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3149
Mailing Address - Country:US
Mailing Address - Phone:714-210-1950
Mailing Address - Fax:714-210-1960
Practice Address - Street 1:17662 IRVINE BLVD
Practice Address - Street 2:STE 14
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3149
Practice Address - Country:US
Practice Address - Phone:714-210-1950
Practice Address - Fax:714-210-1960
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45201183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist