Provider Demographics
NPI:1679728505
Name:BABI, KIDEST (NP)
Entity type:Individual
Prefix:
First Name:KIDEST
Middle Name:
Last Name:BABI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2020 ZONAL AVE RM 430
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90089-0121
Mailing Address - Country:US
Mailing Address - Phone:323-409-3376
Mailing Address - Fax:323-226-2791
Practice Address - Street 1:2010 ZONAL AVE
Practice Address - Street 2:LACUSC MEDICAL CENTER GERIATRIC OPD3P22B
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-226-3638
Practice Address - Fax:323-226-7429
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP11910363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology