Organization
KENNETH TYE, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH TYE M.D. (PRESIDENT)
(626) 960-6588
Entity
Organization
Contact information
Practice address
1250 S SUNSET AVE, #202, WEST COVINA, CA 91790-3961
(626) 960-6588
(626) 338-0688
Mailing address
1250 S SUNSET AVE, #202, WEST COVINA, CA 91790-3961
(626) 960-6588
(626) 338-0688
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A32035
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A320350
—
CA
Enumeration date
02/28/2008
Last updated
02/28/2008
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