Individual
DR. KIRSTEN ELIZABETH MEWALDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4650 LINCOLN BLVD, UNIT #1604, MARINA DEL REY, CA 90292-6306
(626) 354-4874
(650) 723-0121
Mailing address
4650 LINCOLN BLVD, MARINA DEL REY, CA 90292-6306
(310) 448-5200
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A103717
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A1037170
MEDI-CAL
CA
Enumeration date
03/09/2007
Last updated
10/19/2016
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