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NPI Code Detail

MEDICARE: K VU MEDICAL PROFESSIONAL CORPORATION

MEDICARE: K VU MEDICAL PROFESSIONAL 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
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1578989521
Entity Type Code : Organization
Provider Name (Legal Business Name) : K VU MEDICAL PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 505 SHATTO PL
Second Line : #202
City : LOS ANGELES
State : CA
Zip : 90020-1754
Country : US
Telephone Number : 213-368-5062
Fax Number :
Provider Business Practice Location Address
First Line : 505 SHATTO PL
Second Line : #202
City : LOS ANGELES
State : CA
Zip : 90020-1754
Country : US
Telephone Number : 213-368-5062
Fax Number :
Authorized Official
Title or Position : CEO
Name : KHANH VU
Credential : MD
Telephone Number : 213-368-5062
Provider Enumeration Date : 03/14/2014
Last Update Date : 03/14/2014

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Directions to “K VU MEDICAL PROFESSIONAL CORPORATION ” Practice Location

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