Kyle Justin Difulvio, MA
Student in an Organized Health Care Education/Training Program in Santa Monica, CA. Individual provider (NPI-1).
NPI number1699205641
StatusActive
Last updated in NPPESJun 19, 2017
Details
- NPI
- 1699205641
- Entity type
- Individual (NPI-1)
- Name
- Kyle Justin Difulvio
- Credential
- MA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 13, 2017
- Last updated
- Jun 19, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
1527 4th StSanta Monica, CA 90401-2358
Phone 310-394-9871
Mailing address
1527 4th StSanta Monica, CA 90401-2358
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All 172 Student in an Organized Health Care Education/Training Program providers in Santa Monica · All 6,518 providers in Santa Monica
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