Provider Demographics
NPI:1801216361
Name:VIVA FAMILY MEDICAL CENTER, INC
Entity type:Organization
Organization Name:VIVA FAMILY MEDICAL CENTER, 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:
Authorized Official - Last Name:KAYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-483-1928
Mailing Address - Street 1:22337 PACIFIC COAST HWY
Mailing Address - Street 2:441
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265
Mailing Address - Country:US
Mailing Address - Phone:310-871-3434
Mailing Address - Fax:
Practice Address - Street 1:2010 WILSHIRE BLVD
Practice Address - Street 2:506
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3507
Practice Address - Country:US
Practice Address - Phone:310-871-3434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG29768207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty