Healthcare Provider Details

I. General information

NPI: 1528828621
Provider Name (Legal Business Name): KYRA NEWMASTER MD/PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 W SUNSET BLVD
LOS ANGELES CA
90027-6062
US

IV. Provider business mailing address

4650 W SUNSET BLVD
LOS ANGELES CA
90027-6062
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-4703
  • Fax:
Mailing address:
  • Phone: 323-361-2471
  • Fax: 323-361-1109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberA207081
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: