Healthcare Provider Details

I. General information

NPI: 1922209857
Provider Name (Legal Business Name): BRUCE B KADZ M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 N BEDFORD DR STE 201
BEVERLY HILLS CA
90210-4312
US

IV. Provider business mailing address

436 N BEDFORD DR STE 201
BEVERLY HILLS CA
90210-4312
US

V. Phone/Fax

Practice location:
  • Phone: 310-276-3662
  • Fax: 310-276-7049
Mailing address:
  • Phone: 310-276-3662
  • Fax: 310-276-7049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberC2864313
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: