Fred Kyazze M D Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A51997 Issued in CA

Legal business name

FRED KYAZZE M D INC

Doing business as

Gala Care Medical Clinic

Practice address

1410 W Alondra Blvd
Suite C
Compton, CA 90220-3533

Phone

(310) 637-3680

Fax

(310) 637-3679

NPI assigned

May 3, 2011

Last updated

May 3, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Fred Kyazze, M.D.NPI 1033110861

Title

Medical Director

Phone

(310) 637-3680

Specialties & licenses 1

Addresses

Other names 1

• GALA CARE MEDICAL CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fred Boyd Kyazze, MD

  • Family Medicine Physician
  • Compton, CA
  • NPI 1033110861
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304380800000",
    "number": "1528350014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 W ALONDRA BLVD",
            "address_2": "SUITE C",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902203533",
            "telephone_number": "310-637-3680",
            "fax_number": "310-637-3679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 W ALONDRA BLVD",
            "address_2": "SUITE C",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902203533",
            "telephone_number": "310-637-3680",
            "fax_number": "310-637-3679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED KYAZZE M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-03",
        "last_updated": "2011-05-03",
        "status": "A",
        "authorized_official_last_name": "KYAZZE",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-637-3680",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A51997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GALA CARE MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristin Franklin
• Frausto Family Licensed Clinical Social Worker, PC
• Fred Jefferson (Fred Jefferson 142)
• Fred Jefferson Memorial Home for Boys
• Fred Jefferson Memorial Home for Boys
• Free N One, a Drug and Alcohol Free Program
• Free N One, a Drug and Alcohol Free Program
• Cecelia Freeman, PH.D.
• Debra Ann Fresquez, LMFT
• Brenda J Fuentes Gomez

• Primary Care Clinic/Center in Compton, CA
• Providers in Compton, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.