Provider Demographics
NPI:1083276182
Name:KUNALKUMAR K. VYAS D.O. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:KUNALKUMAR K. VYAS D.O. A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KUNALKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:VYAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-386-8440
Mailing Address - Street 1:24331 EL TORO RD STE 360
Mailing Address - Street 2:
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-3134
Mailing Address - Country:US
Mailing Address - Phone:949-386-8440
Mailing Address - Fax:949-386-8441
Practice Address - Street 1:24331 EL TORO RD STE 360
Practice Address - Street 2:
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-3134
Practice Address - Country:US
Practice Address - Phone:949-386-8440
Practice Address - Fax:949-386-8441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty