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General NPI Number Information
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NPI Number | 1811398910
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Entity Type | Organization
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Legal Business Name | KASHYAP TRIVEDI MD INC
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Dates
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Enumeration Date | 09/08/2014
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Last Update Date | 09/08/2014
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Provider Practice Location Address
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Address Line | 4132 KATELLA AVE STE 200
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3496
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Country | US
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Telephone | 562-596-5552
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Fax | 562-596-5340
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Provider Business Mailing Address
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Address Line | 4132 KATELLA AVE STE 200
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3496
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Country | US
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Telephone | 562-596-5552
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Fax | 562-596-5340
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Authorized Official
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Title or Position | OWNER
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Name | KASHYAP TRIVEDI
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Credential |
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Telephone | 562-596-5552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A90430
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License Number State | CA
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