Healthcare Provider Details

I. General information

NPI: 1992894034
Provider Name (Legal Business Name): VLADIMIR KAYE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 N RAYMOND AVE
FULLERTON CA
92831-4609
US

IV. Provider business mailing address

PO BOX 4231
COSTA MESA CA
92628-4231
US

V. Phone/Fax

Practice location:
  • Phone: 714-871-2495
  • Fax: 714-871-3350
Mailing address:
  • Phone: 949-278-9744
  • Fax: 802-609-8435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA64244
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: