MEDICARE: DR. DANIEL KRIVOY M.D.

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	207W00000X	Ophthalmology Physician	A84941	CA
2	207WX0009X	Glaucoma Specialist (Ophthalmology) Physician	A84941	CA

General Provider Information

NPI Number	:	1679531974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL KRIVOY M.D.

Provider Business Mailing Address
First Line	:	9808 VENICE BLVD
Second Line	:	SUITE 400
City	:	CULVER CITY
State	:	CA
Zip	:	90232-2732
Country	:	US
Telephone Number	:	310-838-0202
Fax Number	:

Provider Business Practice Location Address
First Line	:	9808 VENICE BLVD
Second Line	:	#400
City	:	CULVER CITY
State	:	CA
Zip	:	90232-2732
Country	:	US
Telephone Number	:	310-838-0202
Fax Number	:	310-838-8694

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	03/29/2019

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