Organization
KPG CALIFORNIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRYL OLIVIER (CHIEF OPERATIONS OFFICER)
(310) 975-1450
Entity
Organization
Contact information
Practice address
9000 W SUNSET BLVD STE 1500, WEST HOLLYWOOD, CA 90069-5815
(310) 975-1450
Mailing address
9000 W SUNSET BLVD STE 1500, WEST HOLLYWOOD, CA 90069-5815
(310) 975-1450
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
53488
CA
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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