Provider Demographics
NPI:1922209857
Name:KADZ, BRUCE B (MD)
Entity Type:Individual
Prefix:MISS
First Name:BRUCE
Middle Name:B
Last Name:KADZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10724 WILSHIRE BLVD
Mailing Address - Street 2:APT 502
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4447
Mailing Address - Country:US
Mailing Address - Phone:310-420-2090
Mailing Address - Fax:310-276-7049
Practice Address - Street 1:416 N BEDFORD DR
Practice Address - Street 2:SUITE 406
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4322
Practice Address - Country:US
Practice Address - Phone:310-276-3662
Practice Address - Fax:310-276-7049
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC2864313174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist