MEDICARE: ALEX Y KAWANA M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	G68665	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	TIN 954712812	OTHER	CA	SYNERGY
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316951171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX Y KAWANA M.D

Provider Business Mailing Address
First Line	:	PO BOX 48107
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-0107
Country	:	US
Telephone Number	:	323-525-1118
Fax Number	:	818-303-1306

Provider Business Practice Location Address
First Line	:	8737 BEVERLY BLVD
Second Line	:	SUITE # 203
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90048-1828
Country	:	US
Telephone Number	:	323-525-1111
Fax Number	:	323-525-1100

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	05/13/2014

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