Individual
CARLIE KENNEDY THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
191 S BUENA VISTA ST STE 415, BURBANK, CA 91505-4541
(818) 333-2555
(818) 333-2559
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
127831
CA
2086X0206X
Surgical Oncology Physician
Primary
A127831
CA
Other
Enumeration date
06/23/2010
Last updated
12/27/2019
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