Basic Information
| Provider Information | |||||||||
| NPI: | 1467611988 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KURYLO | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 W CENTER STREET PROMENADE STE 300 | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928053960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144494841 | ||||||||
| FaxNumber: | 7149376233 | ||||||||
| Practice Location | |||||||||
| Address1: | 2826 HARRIS ST | ||||||||
| Address2: | |||||||||
| City: | EUREKA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 955034809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074438066 | ||||||||
| FaxNumber: | 7072683251 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2008 | ||||||||
| LastUpdateDate: | 11/05/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 237510 | MA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | A142617 | CA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.