Individual
KELLY KOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
1300 N VERMONT AVE, LOS ANGELES, CA 90027-6098
(847) 602-6399
Mailing address
425 N ALVARADO ST APT 102, LOS ANGELES, CA 90026-4959
(847) 602-6399
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1043908
—
174N00000X
Lactation Consultant (Non-RN)
283972
—
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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