Healthcare Provider Details
I. General information
NPI: 1366863565
Provider Name (Legal Business Name): STEVEN M. KAYE, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/16/2013
Last Update Date: 02/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6331 GREENLEAF AVE STE G
WHITTIER CA
90601-3553
US
IV. Provider business mailing address
15243 LA CRUZ DR 652
PACIFIC PALISADES CA
90272-3616
US
V. Phone/Fax
- Phone: 562-360-1556
- Fax: 206-202-4724
- Phone: 310-871-3434
- Fax: 206-202-4724
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RA0401X |
| Taxonomy | Addiction Medicine (Internal Medicine) Physician |
| License Number | G029768 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
STEVEN
M
KAYE
Title or Position: CEO
Credential: MD
Phone: 310-871-3434