Individual
KIMBERLY HAGEN TILLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2021 SANTA MONICA BLVD, SUIT 400E, SANTA MONICA, CA 90404-2208
(310) 453-5654
Mailing address
7819 BLERIOT AVE, LOS ANGELES, CA 90045-2904
(310) 649-3239
Taxonomy
Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
Primary
375548
CA
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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