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General NPI Number Information
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NPI Number | 1659452969
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Entity Type | Individual
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Provider Name | KAYVON K. YADIDI D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 1400 S GRAND AVE STE 703
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City | LOS ANGELES
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State | CA
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Zip | 90015-3068
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Country | US
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Telephone | 323-408-8532
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Fax | 323-408-8534
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Provider Business Mailing Address
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Address Line | 10573 W PICO BLVD # 328
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City | LOS ANGELES
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State | CA
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Zip | 90064-2333
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Country | US
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Telephone | 109-481-8013
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 20A6595
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20A6595
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License Number State | CA
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