Provider Demographics
NPI:1336757970
Name:KURDIN, ANTON
Entity Type:Individual
Prefix:
First Name:ANTON
Middle Name:
Last Name:KURDIN
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 1:3 WAVERLEY CRESCENT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L4C 8Z5
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:370 DEL NORTE AVE STE 201
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4142
Practice Address - Country:US
Practice Address - Phone:530-751-7201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA168976207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery