| Tim Gurtch Md, Inc. | |
|
4276 54-th Place Suite A San Diego CA 92115 | |
| (619) 265-1070 | |
| (619) 265-5414 |
| Full Name | Tim Gurtch Md, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 4276 54-th Place, San Diego, California |
| Authorized Official Name and Position | Tim Platon Gurtch (PRESIDENT) |
| Authorized Official Contact | 6194255228 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tim Gurtch Md, Inc. 4276 54th Pl Suite A San Diego CA 92115-6011 Ph: (619) 265-1070 | Tim Gurtch Md, Inc. 4276 54-th Place Suite A San Diego CA 92115 Ph: (619) 265-1070 |
| NPI Number | 1932264801 |
|---|---|
| Provider Enumeration Date | 12/22/2006 |
| Last Update Date | 03/26/2013 |
| Medicare PECOS PAC ID | 3577580406 |
|---|---|
| Medicare Enrollment ID | O20051028001056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932264801 | NPI | - | NPPES |
| GR0102270 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C50806 (California) | Primary |
| Provider Name | Alexander A Krakovsky |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1023096443 PECOS PAC ID: 5698670800 Enrollment ID: I20031201000807 |
| Provider Name | Tim P Gurtch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881694776 PECOS PAC ID: 1759272743 Enrollment ID: I20040320000734 |
| Provider Name | Howard A Kurshenbaum |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1538217476 PECOS PAC ID: 1153452826 Enrollment ID: I20100623000931 |
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