Kyle Mistretta
Student in an Organized Health Care Education/Training Program in Los Angeles, CA. Individual provider (NPI-1).
Details
- NPI
- 1003676685
- Entity type
- Individual (NPI-1)
- Name
- Kyle Mistretta
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 20, 2024
- Certification date
- Mar 19, 2024
- Last updated
- Mar 20, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | CA | Yes |
Practice location
4650 W Sunset BlvdLos Angeles, CA 90027-6062
Phone 323-361-4703
Mailing address
4650 W Sunset BlvdLos Angeles, CA 90027-6062
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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