Organization
JOHN KAYVANFAR MD INC
Active
Other names
Olympic Orthopedic Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KAYVENFAR MD (OWNER)
(661) 947-0078
Entity
Organization
Contact information
Practice address
1224 E AVENUE S STE C, PALMDALE, CA 93550-6180
(661) 947-0078
Mailing address
PO BOX 260916, ENCINO, CA 91426-0916
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A36821
CA
207X00000X
Orthopaedic Surgery Physician
Primary
A36821
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A368210
—
CA
Enumeration date
02/14/2008
Last updated
07/10/2008
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