| Fred Kyazze M D Inc | |
|
1410 W Alondra Blvd Suite C Compton CA 90220-3533 | |
| (310) 637-3680 | |
| (310) 637-3679 |
| Full Name | Fred Kyazze M D Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1410 W Alondra Blvd, Compton, California |
| Authorized Official Name and Position | Fred Kyazze (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3106373680 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fred Kyazze M D Inc 1410 W Alondra Blvd Suite C Compton CA 90220-3533 Ph: (310) 637-3680 | Fred Kyazze M D Inc 1410 W Alondra Blvd Suite C Compton CA 90220-3533 Ph: (310) 637-3680 |
| NPI Number | 1528350014 |
|---|---|
| Provider Enumeration Date | 05/03/2011 |
| Last Update Date | 05/03/2011 |
| Medicare PECOS PAC ID | 2860678273 |
|---|---|
| Medicare Enrollment ID | O20110519000691 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528350014 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A51997 (California) | Primary |
| Provider Name | Fred B Kyazze |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033110861 PECOS PAC ID: 4486830890 Enrollment ID: I20110519000774 |
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