Provider Demographics
NPI:1922043710
Name:MARC J KAYEM MD INC
Entity Type:Organization
Organization Name:MARC J KAYEM MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KAYEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-777-7879
Mailing Address - Street 1:120 S SPALDING DR
Mailing Address - Street 2:STE 340
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-1800
Mailing Address - Country:US
Mailing Address - Phone:310-777-7879
Mailing Address - Fax:310-861-1729
Practice Address - Street 1:120 S SPALDING DR
Practice Address - Street 2:STE 340
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-1800
Practice Address - Country:US
Practice Address - Phone:310-777-7879
Practice Address - Fax:310-861-1729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49693207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16158OtherGROUP PROVIDER ID
CAW16158OtherGROUP PROVIDER ID