MEDICARE: JULIUS C KPADUWA MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	G51500	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	G51500	OTHER	CA	M.D
3	A56261	OTHER	CA	M.D

General Provider Information

NPI Number	:	1396893723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULIUS C KPADUWA MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	16008 AMAR RD
Second Line	:
City	:	CITY OF INDUSTRY
State	:	CA
Zip	:	91744-2203
Country	:	US
Telephone Number	:	626-330-9535
Fax Number	:	626-330-2661

Provider Business Practice Location Address
First Line	:	11036 VALLEY MALL
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91731-2617
Country	:	US
Telephone Number	:	626-575-8342
Fax Number	:

Authorized Official
Title or Position	:	M.D.
Name	:	JULIUS C KPADUWA
Credential	:
Telephone Number	:	626-330-9535

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	04/15/2010

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