Individual provider · Type 1 NPI

Kyle Vivo, PA-C

Medical Physician Assistant · Los Angeles, CA

NPI number 1407982689 Active

Practice location

311 Winston St
Los Angeles, CA 90013-1519

Call (213) 893-1960 Map

Mailing address

2126 Mozart St
Los Angeles, CA 90031-2246

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X18774 (CA)

Medical Physician Assistant: Definition to come...

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About NPI 1407982689

Kyle Vivo, PA-C's National Provider Identifier is 1407982689, issued on Feb 24, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Los Angeles, CA. The record was last updated on Jul 8, 2007.