Healthcare Provider Details

I. General information

NPI: 1558265843
Provider Name (Legal Business Name): KP PLASTIC SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N LA CIENEGA BLVD STE 150
BEVERLY HILLS CA
90211-3143
US

IV. Provider business mailing address

50 N LA CIENEGA BLVD STE 150
BEVERLY HILLS CA
90211-3143
US

V. Phone/Fax

Practice location:
  • Phone: 843-457-9002
  • Fax:
Mailing address:
  • Phone: 843-457-9002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHINWE KPADUWA
Title or Position: PLASTIC SURGEON
Credential: MD
Phone: 202-687-1856