Provider Demographics
NPI:1366863565
Name:STEVEN M. KAYE, MD, INC
Entity Type:Organization
Organization Name:STEVEN M. KAYE, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-871-3434
Mailing Address - Street 1:15243 LA CRUZ DR
Mailing Address - Street 2:652
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3616
Mailing Address - Country:US
Mailing Address - Phone:310-871-3434
Mailing Address - Fax:206-202-4724
Practice Address - Street 1:6331 GREENLEAF AVE
Practice Address - Street 2:STE G
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-3553
Practice Address - Country:US
Practice Address - Phone:562-360-1556
Practice Address - Fax:206-202-4724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG029768207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB213675Medicare PIN
CACB213674Medicare PIN