Provider Demographics
NPI:1477710028
Name:FOSTER, CURTIS ALAN
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:ALAN
Last Name:FOSTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S GAFFEY ST
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-4628
Mailing Address - Country:US
Mailing Address - Phone:310-548-0201
Mailing Address - Fax:310-548-4492
Practice Address - Street 1:1600 S GAFFEY ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-4628
Practice Address - Country:US
Practice Address - Phone:310-548-0201
Practice Address - Fax:310-548-4492
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG55593207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine