Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Kyle Vivo, PA-C

Individual provider Medical Physician Assistant · NPI 1407982689

Mr. Kyle Vivo, PA-C is a Physician Assistant in Los Angeles, California. Qualified in 2006, 20 years ago. Accepts Medicare assignment. Licensed in California.

Years since qualifying
20
Licensed in
CA
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

311 Winston St
Los Angeles, CA 90013-1519
Phone: (213) 893-1960
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 18774 (CA)

Record details

NPI number1407982689
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 24, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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