NPI Code Details Logo

NPI 1891067682

NPI 1891067682 : KIMBERLY ANN DURDIN LM, IBCLC : LOS ANGELES, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1891067682
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    KIMBERLY ANN DURDIN LM, IBCLC
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/08/2012
-----------------------------------------------------
    Last Update Date     |    09/11/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2610 SOUTHWEST DR 
-----------------------------------------------------
    City                 |    LOS ANGELES
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    90043-4528
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    323-381-5511
-----------------------------------------------------
    Fax                  |    310-861-0255
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2610 SOUTHWEST DR 
-----------------------------------------------------
    City                 |    LOS ANGELES
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    90043-4528
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    323-381-5511
-----------------------------------------------------
    Fax                  |    310-861-0255
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    174N00000X
-----------------------------------------------------
    Taxonomy Name        |    Lactation Consultant (Non-RN)
-----------------------------------------------------
    License Number       |    10218057
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.