Individual
MR. KYLE VIVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
311 WINSTON ST, LOS ANGELES, CA 90013-1519
(213) 893-1960
Mailing address
2126 MOZART ST, LOS ANGELES, CA 90031-2246
(626) 674-8109
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
18774
CA
Other
Enumeration date
02/24/2007
Last updated
07/08/2007
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