Provider Demographics
NPI:1932695483
Name:KURZULIAN, MICHAEL MANUK
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:MANUK
Last Name:KURZULIAN
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 1:3201 N. GLENOAKS BLVD.
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-2009
Mailing Address - Country:US
Mailing Address - Phone:818-848-3293
Mailing Address - Fax:818-848-9943
Practice Address - Street 1:3201 N. GLENOAKS BLVD.
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-2009
Practice Address - Country:US
Practice Address - Phone:818-848-3293
Practice Address - Fax:818-848-9943
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF4854569343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)