Healthcare Provider Details

I. General information

NPI: 1285195347
Provider Name (Legal Business Name): KAITLIN MAE ARENA MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 S OLIVE ST
LOS ANGELES CA
90015-3023
US

IV. Provider business mailing address

1530 S OLIVE ST
LOS ANGELES CA
90015-3023
US

V. Phone/Fax

Practice location:
  • Phone: 213-747-5542
  • Fax: 818-907-0360
Mailing address:
  • Phone: 213-747-5542
  • Fax: 818-907-0360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA178534
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: