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General NPI Number Information
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NPI Number | 1033399498
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Entity Type | Organization
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Legal Business Name | UNIVERSAL DIAGNOSTIC MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 4322 WILSHIRE BLVD STE 303
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City | LOS ANGELES
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State | CA
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Zip | 90010-3793
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Country | US
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Telephone | 310-822-1522
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Fax | 206-202-4724
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Provider Business Mailing Address
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Address Line | 11901 SANTA MONICA BLVD 468
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City | LOS ANGELES
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State | CA
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Zip | 90025-2767
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Country | US
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Telephone | 310-828-1522
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Fax | 206-202-4724
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Authorized Official
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Title or Position | CEO
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Name | DR. STEVEN KAYE
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Credential | MD
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Telephone | 310-828-1522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0901X
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Taxonomy Name | Otology & Neurotology Physician
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License Number | G29768
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License Number State | CA
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