Provider Demographics
NPI:1679656946
Name:KURTZ, ALLAN LEE (DO)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:LEE
Last Name:KURTZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6325 TOPANGA CANYON BLVD STE 501
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-2052
Mailing Address - Country:US
Mailing Address - Phone:818-346-1440
Mailing Address - Fax:818-346-9356
Practice Address - Street 1:6325 TOPANGA CANYON BLVD STE 501
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2052
Practice Address - Country:US
Practice Address - Phone:818-346-1440
Practice Address - Fax:818-346-9356
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A4625207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33080508Medicaid
CA20A4625Medicare ID - Type Unspecified
CA33080508Medicaid