Individual
KIMBERLY MISLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10833 LECONTE AVE., LOS ANGELES, CA 90095-3075
(310) 794-1355
(310) 301-8751
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 301-8708
(310) 301-8751
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A79154
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A791540
—
CA
Enumeration date
07/28/2006
Last updated
02/05/2009
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