Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 283727 | MA |
Y | 208800000X | Urologist | A128244 | CA |
NPI | 1013203165 |
---|---|
Provider Name | Robert Lurvey |
First Address | Los Altos, CA 94022-1408 |
Second Address | Antioch, CA 94531-6210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2011 |
Last Update Date | 11/02/2022 |