Individual
VIVY TRAN CUSUMANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1223 16TH ST STE 3100, SANTA MONICA, CA 90404-1275
(310) 582-6240
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8707
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A158805
CA
Other
Enumeration date
03/22/2017
Last updated
08/01/2023
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