Healthcare Provider Details

I. General information

NPI: 1881859304
Provider Name (Legal Business Name): KIKI L HURT, MD APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2008
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 S HOPE ST APT 1116
LOS ANGELES CA
90015-2190
US

IV. Provider business mailing address

1100 S HOPE ST APT 1116
LOS ANGELES CA
90015-2190
US

V. Phone/Fax

Practice location:
  • Phone: 562-394-7376
  • Fax:
Mailing address:
  • Phone: 562-394-7376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA96718
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberA96718
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA96718
License Number StateCA

VIII. Authorized Official

Name: DR. KIKI LOLITA HURT
Title or Position: ANESTHESIOLOGIST/ INTERNIST
Credential: MD
Phone: 562-394-7376