Healthcare Provider Details

I. General information

NPI: 1801216361
Provider Name (Legal Business Name): VIVA FAMILY MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2014
Last Update Date: 04/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 WILSHIRE BLVD 506
LOS ANGELES CA
90057-3507
US

IV. Provider business mailing address

22337 PACIFIC COAST HWY 441
MALIBU CA
90265
US

V. Phone/Fax

Practice location:
  • Phone: 310-871-3434
  • Fax:
Mailing address:
  • Phone: 310-871-3434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG29768
License Number StateCA

VIII. Authorized Official

Name: DR. STEVEN KAYE
Title or Position: CEO
Credential: MD
Phone: 213-483-1928