Healthcare Provider Details

I. General information

NPI: 1962847400
Provider Name (Legal Business Name): CATHERINE KILEY MONAHAN NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2013
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 ROSECRANS AVE # 3230
EL SEGUNDO CA
90245-4749
US

IV. Provider business mailing address

1950 SAWTELLE BLVD STE 150
LOS ANGELES CA
90025-7073
US

V. Phone/Fax

Practice location:
  • Phone: 323-628-8671
  • Fax:
Mailing address:
  • Phone: 310-481-3939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.1001196-NP
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number12247
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: