Provider Demographics
NPI:1639948557
Name:DETERMINED MEDICAL INC
Entity Type:Organization
Organization Name:DETERMINED MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:KAISER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-866-7800
Mailing Address - Street 1:3019 OCEAN PARK BLVD # 154
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-3004
Mailing Address - Country:US
Mailing Address - Phone:800-800-0211
Mailing Address - Fax:
Practice Address - Street 1:3415 S SEPULVEDA BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-6292
Practice Address - Country:US
Practice Address - Phone:800-800-0211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-20
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty