Provider Demographics
NPI:1679903454
Name:PINANGO, KYRA E (MD)
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:E
Last Name:PINANGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 ALPENGLOW LN
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-8506
Mailing Address - Country:US
Mailing Address - Phone:406-222-0800
Mailing Address - Fax:406-222-7606
Practice Address - Street 1:320 ALPENGLOW LN
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-8506
Practice Address - Country:US
Practice Address - Phone:406-222-0800
Practice Address - Fax:406-222-7606
Is Sole Proprietor?:No
Enumeration Date:2013-11-15
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN17608207Q00000X
FLME118597207Q00000X
MT49798207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine