MEDICARE: JULIUS C KPADUWA MEDICAL CORPORATION

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	208000000X	Pediatrics Physician	A56261	CA
2	207VX0000X	Obstetrics Physician	G51500	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790975258
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULIUS C KPADUWA MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	9573 GARVEY AVE
Second Line	:	STE 17
City	:	S EL MONTE
State	:	CA
Zip	:	91733-4606
Country	:	US
Telephone Number	:	626-454-1801
Fax Number	:	626-454-2203

Provider Business Practice Location Address
First Line	:	16008 AMAR RD
Second Line	:
City	:	CITY OF INDUSTRY
State	:	CA
Zip	:	91744-2203
Country	:	US
Telephone Number	:	626-330-9535
Fax Number	:	626-330-2661

Authorized Official
Title or Position	:	MD
Name	:	MR. JULIUS C KPADUWA
Credential	:	MD
Telephone Number	:	626-454-1801

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	04/19/2010

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