Healthcare Provider Details

I. General information

NPI: 1952644072
Provider Name (Legal Business Name): KYLE WHITNEY MONK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 11/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 WILSHIRE BLVD 201
LOS ANGELES CA
90036-4870
US

IV. Provider business mailing address

8501 WILSHIRE BLVD 201
BEVERLY HILLS CA
90211
UM

V. Phone/Fax

Practice location:
  • Phone: 310-385-3345
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number143693
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: