Organization
ENDOCRINOLOGY & DIABETES SPECIALTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEX KUTAS MD (PRESIDENT OWNER)
(562) 634-9803
Entity
Organization
Contact information
Practice address
3300 E SOUTH STREET, SUITE 103, LONG BEACH, CA 90805
(562) 634-9803
(562) 634-9845
Mailing address
3300 E SOUTH ST, SUITE 103, LAKEWOOD, CA 90805-4549
(562) 634-9803
(562) 634-9845
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC9614
RAILROAD MEDICARE
CA
01
—
ZZZ09897Z
BLUE SHIELD
CA
Enumeration date
09/12/2006
Last updated
04/20/2015
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