Provider Demographics
NPI:1457614497
Name:KURZBARD-ROACH, NICOLE ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:ELIZABETH
Last Name:KURZBARD-ROACH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:757 WESTWOOD PLZ
Mailing Address - Street 2:DEPARTMENT OF RADIOLOGY SUITE 1638
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-7437
Mailing Address - Country:US
Mailing Address - Phone:310-206-6766
Mailing Address - Fax:
Practice Address - Street 1:757 WESTWOOD PLZ
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY SUITE 1638
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-7437
Practice Address - Country:US
Practice Address - Phone:310-206-6766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1279852085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging