Healthcare Provider Details

I. General information

NPI: 1881778124
Provider Name (Legal Business Name): LLOYD MATTHEW KRIEGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 N RODEO DR
BEVERLY HILLS CA
90210-4536
US

IV. Provider business mailing address

421 N RODEO DR
BEVERLY HILLS CA
90210-4536
US

V. Phone/Fax

Practice location:
  • Phone: 310-550-6300
  • Fax: 310-550-6363
Mailing address:
  • Phone: 310-550-6300
  • Fax: 310-550-6363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA55627
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: