Provider Demographics
NPI:1568834059
Name:KEITH A HURVITZ M D A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:KEITH A HURVITZ M D A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:HURVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-595-6543
Mailing Address - Street 1:6226 E SPRING ST STE 380
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1444
Mailing Address - Country:US
Mailing Address - Phone:562-595-6543
Mailing Address - Fax:562-595-1414
Practice Address - Street 1:6226 E SPRING ST STE 380
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1444
Practice Address - Country:US
Practice Address - Phone:562-595-6543
Practice Address - Fax:562-595-1414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-23
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74511208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty