Provider Demographics
NPI:1235189747
Name:KAY, RICHARD (MD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:KAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4161 W. REDONDO BEACH BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-3306
Mailing Address - Country:US
Mailing Address - Phone:310-214-8677
Mailing Address - Fax:310-921-1718
Practice Address - Street 1:5000 OVERLAND AVE.
Practice Address - Street 2:#5
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230
Practice Address - Country:US
Practice Address - Phone:310-280-2700
Practice Address - Fax:310-837-7334
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55735207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A55735Medicaid
CA00A557350OtherMEDI-CAL
CA00A557350Medicaid
CA00A557350Medicaid
CA00A557350Medicaid
CABK4679657OtherDEA NUMBER
CA00A557350OtherMEDI-CAL