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General NPI Number Information
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NPI Number | 1811922727
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Entity Type | Individual
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Provider Name | CHRISTIE KAY KIDD PA C
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Gender | Female
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 433 N CAMDEN DR SUITE 805
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City | BEVERLY HILLS
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State | CA
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Zip | 90210
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Country | US
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Telephone | 310-550-7661
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Fax | 310-550-1920
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Provider Business Mailing Address
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Address Line | 1140 MANHATTAN BEACH BLVD UNIT H
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266
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Country | US
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Telephone | 310-545-9309
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA14436
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA14436
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License Number State | CA
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