Provider Demographics
NPI:1992894034
Name:KAYE, VLADIMIR (MD)
Entity type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:
Last Name:KAYE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4231
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92628-4231
Mailing Address - Country:US
Mailing Address - Phone:949-278-9744
Mailing Address - Fax:802-609-8435
Practice Address - Street 1:159 N RAYMOND AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-4609
Practice Address - Country:US
Practice Address - Phone:714-871-2495
Practice Address - Fax:714-871-3350
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA642442081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA64244OtherCA MEDICAL LICENSE
CAA64244OtherCA MEDICAL LICENSE