Individual
DR. ALEX KUTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3300 E SOUTH ST, 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
G30388
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G303880
—
CA
01
—
P00200693
RAILROAD MEDICARE
CA
01
—
W18004
MEDICARE GROUP ID
CA
01
—
W18004A
MEDICARE GROUP ID
CA
Enumeration date
09/08/2006
Last updated
03/21/2008
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