MEDICARE: KYLIE KING VANOVER M.S., R.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	133N00000X	Nutritionist
2	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian
3	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1275904450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLIE KING VANOVER M.S., R.D.

Provider Business Mailing Address
First Line	:	12946 VALLEYHEART DRIVE
Second Line	:	SUITE 213
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-1971
Country	:	US
Telephone Number	:	323-422-0222
Fax Number	:

Provider Business Practice Location Address
First Line	:	3401 BARHAM BLVD
Second Line	:	SUITE 4
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-1289
Country	:	US
Telephone Number	:	323-422-0222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2015
Last Update Date	:	11/03/2020

Similar Medicare Providers

1831308881 — MR. BON WOOK KOO LAC
Practice Location Address:

2833 W 8TH ST STE 101
LOS ANGELES, CA
90005-1289

Practice Phone: 213-427-1299
Practice Fax:

1144018391 — REIGN RECOVERY INC
Practice Location Address:

1289 S SYCAMORE AVE
LOS ANGELES, CA
90019-1550

Practice Phone: 323-356-3668
Practice Fax:

1427908771 — CHARLOTTE ROBINSON
Practice Location Address:

1289 S DUNSMUIR AVE
LOS ANGELES, CA
90019-2627

Practice Phone: 323-252-1867
Practice Fax:

1346019825 — AMY SCHAFFER
Practice Location Address:

6767 FOREST LAWN DR STE 100
LOS ANGELES, CA
90068-1027

Practice Phone: 310-374-3300
Practice Fax: 310-374-3307

1982536710 — JAMILAH AMMARI-MONDRAGON
Practice Location Address:

6767 FOREST LAWN DR
LOS ANGELES, CA
90068-1027

Practice Phone: 310-747-4237
Practice Fax:

1164078150 — JOSE DANIEL LOPEZ
Practice Location Address:

6767 FOREST LAWN DR STE 100&103
LOS ANGELES, CA
90068-1027

Practice Phone: 310-374-3300
Practice Fax: 310-374-3307

Directions to “ KYLIE KING VANOVER M.S., R.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.