Individual provider · Type 1 NPI

Vitaley Kovalev, PA-C, DO

Student in an Organized Health Care Education/Training Program · Los Angeles, CA

NPI number 1750637740 Active

Practice location

10100 S San Pedro St
Los Angeles, CA 90003-4830

Call (323) 578-5451 Map

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700X0010-03549 (NC)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1750637740

Vitaley Kovalev, PA-C, DO's National Provider Identifier is 1750637740, issued on Jul 27, 2012. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Los Angeles, CA. The record was last updated on Apr 26, 2021.