Provider Demographics
NPI:1295922300
Name:JOSHUA M KAYE, DPM, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:JOSHUA M KAYE, DPM, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAYE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:310-641-3555
Mailing Address - Street 1:8540 S SEPULVEDA BLVD
Mailing Address - Street 2:106
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3807
Mailing Address - Country:US
Mailing Address - Phone:310-641-3555
Mailing Address - Fax:310-337-7540
Practice Address - Street 1:8540 S SEPULVEDA BLVD
Practice Address - Street 2:106
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3807
Practice Address - Country:US
Practice Address - Phone:310-641-3555
Practice Address - Fax:310-337-7540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAWE6984213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E24040Medicaid
CAWE6984Medicare PIN
CA000E24040Medicaid