Individual
DR. KEVIN O BELGRAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 W CARSON ST, RB2 BOX 405, TORRANCE, CA 90502-2004
(310) 222-2515
(310) 787-0448
Mailing address
1011 BALDWIN PARK BLVD, BALDWIN PARK, CA 91706-5806
(626) 484-5257
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301100865
MI
207RC0000X
Cardiovascular Disease Physician
Primary
A142990
CA
208000000X
Pediatrics Physician
4301100865
MI
Other
Enumeration date
06/07/2012
Last updated
11/23/2021
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