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Organization
ORIGINAL BREATH
Active
Organization
ORIGINAL BREATH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE BURTON DAOM (PHYSICIAN)
(310) 980-9764
Entity
Organization
Contact information
Practice address
1106 N LA CIENEGA BLVD STE 203, WEST HOLLYWOOD, CA 90069-2493
(310) 659-8500
(310) 504-3171
Mailing address
1106 N LA CIENEGA BLVD STE 206, WEST HOLLYWOOD, CA 90069-2493
(310) 980-9764
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
04/17/2020
Last updated
09/15/2021
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