Provider Demographics
NPI:1881154599
Name:MURGIA, KEVAN CORDELL
Entity type:Individual
Prefix:MR
First Name:KEVAN
Middle Name:CORDELL
Last Name:MURGIA
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 1:2745 CEANOTHUS AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-8279
Mailing Address - Country:US
Mailing Address - Phone:530-566-2093
Mailing Address - Fax:
Practice Address - Street 1:2745 CEANOTHUS AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-8279
Practice Address - Country:US
Practice Address - Phone:530-566-2093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program