Provider Demographics
NPI:1710925409
Name:COMBS, CURTISS WALTER (MD)
Entity Type:Individual
Prefix:DR
First Name:CURTISS
Middle Name:WALTER
Last Name:COMBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CURTISS
Other - Middle Name:WALTER
Other - Last Name:COMBS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:31720 TEMECULA PKWY
Mailing Address - Street 2:STE 203
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-5895
Mailing Address - Country:US
Mailing Address - Phone:951-302-4700
Mailing Address - Fax:
Practice Address - Street 1:31720 TEMECULA PKWY
Practice Address - Street 2:STE 203
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-5895
Practice Address - Country:US
Practice Address - Phone:951-302-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67044207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH18966Medicare UPIN