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General NPI Number Information
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NPI Number | 1780733048
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Entity Type | Organization
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Legal Business Name | JULIUS C. KPADUWA MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 11/27/2017
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Provider Practice Location Address
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Address Line | 15913 AMAR RD
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City | LA PUENTE
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State | CA
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Zip | 91744-2202
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Country | US
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Telephone | 626-330-9535
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Fax | 626-330-2661
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Provider Business Mailing Address
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Address Line | 15913 AMAR RD
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City | LA PUENTE
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State | CA
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Zip | 91744-2202
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Country | US
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Telephone | 626-330-9535
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Fax | 626-330-2661
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Authorized Official
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Title or Position | OWNER
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Name | JULIUS C KPADUWA
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Credential | MD
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Telephone | 626-330-9535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G51500
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License Number State | CA
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