Healthcare Provider Details

I. General information

NPI: 1437723145
Provider Name (Legal Business Name): DO MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 N CENTRAL AVE STE 235
GLENDALE CA
91203-2059
US

IV. Provider business mailing address

18107 SHERMAN WAY STE 204
RESEDA CA
91335-8802
US

V. Phone/Fax

Practice location:
  • Phone: 818-484-6592
  • Fax:
Mailing address:
  • Phone: 818-484-6592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN DO
Title or Position: OWNER
Credential: MD
Phone: 818-484-6592