Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 20A15244 | CA |
N | 207YS0123X | Facial Plastic Surgeon | 20A15244 | CA |
NPI | 1922395516 |
---|---|
Provider Name | Monica Chau Quynh Kieu |
First Address | Torrance, CA 90510-3098 |
Second Address | Marina Del Rey, CA 90292-6634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2011 |
Last Update Date | 18/07/2017 |