Individual
KATELYN SMITH KONDRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 N STATE ST, CLINIC TOWER, SUITE A7D, LOS ANGELES, CA 90033-1029
(310) 804-4665
Mailing address
16212 SHADOW MOUNTAIN DR, PACIFIC PALISADES, CA 90272-2300
(310) 804-4665
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
164587
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/21/2018
Last updated
03/01/2022
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