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NPI Code Detail

MEDICARE: CHLOE KINMAN

MEDICARE: CHLOE KINMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker93327CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
193327OTHERCAAETNA

General Provider Information

NPI Number : 1508572512
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHLOE KINMAN
Provider Business Mailing Address
First Line : 5342 FOUNTAIN AVE APT 302
Second Line :
City : LOS ANGELES
State : CA
Zip : 90029-1282
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12424 WILSHIRE BLVD STE 650
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-1081
Country : US
Telephone Number : 310-571-8760
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2023
Last Update Date : 01/24/2023

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Directions to “ CHLOE KINMAN ” Practice Location

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