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General NPI Number Information
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NPI Number | 1932642477
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Entity Type | Organization
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Legal Business Name | KPW UROLOGY SPECIALTY GROUP
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Dates
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Enumeration Date | 12/01/2016
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Last Update Date | 12/01/2016
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Provider Practice Location Address
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Address Line | 3445 PACIFIC COAST HWY SUITE 310
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City | TORRANCE
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State | CA
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Zip | 90505-6658
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Country | US
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Telephone | 310-602-5005
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Fax | 310-373-7895
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Provider Business Mailing Address
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Address Line | 3445 PACIFIC COAST HWY SUITE 310
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City | TORRANCE
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State | CA
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Zip | 90505-6658
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Country | US
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Telephone | 310-602-5005
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Fax | 310-373-7895
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Authorized Official
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Title or Position | MANAGER
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Name | MS. HEATHER ANN OSKOWIS
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Credential |
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Telephone | 615-478-9667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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