Provider Demographics
NPI:1205913621
Name:CURTIS, ERNEST N (MD)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:N
Last Name:CURTIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 E 17TH ST STE 118
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8627
Mailing Address - Country:US
Mailing Address - Phone:714-547-3346
Mailing Address - Fax:714-547-3252
Practice Address - Street 1:2801 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806
Practice Address - Country:US
Practice Address - Phone:714-547-3346
Practice Address - Fax:714-547-3252
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26080207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24718OtherUPIN
CA00A260800Medicaid
CACB303193OtherMEDICARE