Individual
JACLYN MICHELLE KAPPICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., M.D.
Contact information
Practice address
757 WESTWOOD PLZ, LOS ANGELES, CA 90095-7419
(310) 267-9129
Mailing address
757 WESTWOOD PLZ, B711 RRUMC, LOS ANGELES, CA 90095-7419
(310) 267-9129
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
A148463
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2015
Last updated
06/12/2021
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