Healthcare Provider Details

I. General information

NPI: 1922043710
Provider Name (Legal Business Name): MARC J KAYEM MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 11/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 S SPALDING DR STE 340
BEVERLY HILLS CA
90212-1800
US

IV. Provider business mailing address

120 S SPALDING DR STE 340
BEVERLY HILLS CA
90212-1800
US

V. Phone/Fax

Practice location:
  • Phone: 310-777-7879
  • Fax: 310-861-1729
Mailing address:
  • Phone: 310-777-7879
  • Fax: 310-861-1729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberA49693
License Number StateCA

VIII. Authorized Official

Name: DR. MARC JOHN KAYEM
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-777-7879