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General NPI Number Information
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NPI Number | 1659463966
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Entity Type | Organization
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Legal Business Name | J.KEVIN DRURY, M.D., F.A.C.C.
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8635 W 3RD STREET STE 1050W
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City | LOS ANGELES
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State | CA
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Zip | 90048
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Country | US
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Telephone | 310-659-8371
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Fax |
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Provider Business Mailing Address
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Address Line | 8635 W 3RD STREET STE 1050W
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City | LOS ANGELES
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State | CA
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Zip | 90048
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Country | US
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Telephone | 310-659-8371
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. ROSE LEVINE
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Credential |
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Telephone | 310-659-8371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A39080
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License Number State | CA
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