MEDICARE: K KAY DURAIRAJ MD A 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	261QH0100X	Health Service Clinic/Center	A56015	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

General Provider Information

NPI Number	:	1881914646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K KAY DURAIRAJ MD A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	800 S. FAIRMOUNT AVE
Second Line	:	SUITE 210
City	:	PASADENA
State	:	CA
Zip	:	91105-3152
Country	:	US
Telephone Number	:	626-316-7033
Fax Number	:	626-539-2529

Provider Business Practice Location Address
First Line	:	800 S. FAIRMOUNT AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-3152
Country	:	US
Telephone Number	:	626-316-7033
Fax Number	:	626-539-2529

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. KAY DURAIRAJ
Credential	:	MD
Telephone Number	:	62633167033

Provider Enumeration Date	:	06/03/2010
Last Update Date	:	10/10/2012

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