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General NPI Number Information
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NPI Number | 1770553364
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Entity Type | Individual
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Provider Name | JOSEPH M KUDERKO MD
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 20911 EARL ST STE 470
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City | TORRANCE
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State | CA
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Zip | 90503-4355
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Country | US
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Telephone | 310-372-0700
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Fax | 310-372-0774
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Provider Business Mailing Address
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Address Line | PO BOX 3098
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City | TORRANCE
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State | CA
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Zip | 90510-3098
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Country | US
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Telephone | 310-792-3914
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Fax | 855-898-4055
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | G152916
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License Number State | CA
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