Individual
KYLE ELLIOTT MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 SAN PABLO ST FL 7, LOS ANGELES, CA 90033-5313
(323) 442-6254
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-6254
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
18141
NV
2086S0102X
Surgical Critical Care Physician
Primary
A129020
CA
Other
Enumeration date
08/14/2012
Last updated
11/05/2020
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