DR. BOUNMANY KYLE KEOJAMPA (NPI# 1972778843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972778843 |
| Entity Type | Individual |
| Full Name | DR. BOUNMANY KYLE KEOJAMPA |
| Credential | M.D. |
| Practice Address |
4640 Admiralty Way Suite 718 Marina Del Rey CA 90292-6621 |
| Practice Telephone | 3108234444 |
| Practice Fax Number | 8888574458 |
| Mailing Telephone | 3108234444 |
| Mailing Fax Number | 8888574458 |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2015-07-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
134756 | CA | Allopathic & Osteopathic Physicians |
| N | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
242360 | MA | Allopathic & Osteopathic Physicians |
| Street Address |
4640 ADMIRALTY WAY SUITE 718 |
| City | MARINA DEL REY |
| State | CA |
| Zip Code | 90292-6621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932153731 | Mahua Biswas | Radiology | 4640 Admiralty Way, Suite 102, Marina Del Rey, CA 90292-6629 | 2006-05-19 |
| 1427593805 | Western Imaging Marina Del Rey Inc | Clinic/Center | 4640 Admiralty Way, Suite 102, Marina Del Rey, CA 90292-6621 | 2016-12-21 |
| 1376097790 | Del Rey Sinus & Allergy Institute Inc | Otolaryngology | 4640 Admiralty Way, Suite #718, Marina Del Rey, CA 90292-6621 | 2016-08-15 |
| 1508293853 | Admiralty Surgery Center, Inc | Clinic/Center | 4640 Admiralty Way, Suite 718b, Marina Del Rey, CA 90292-6621 | 2013-10-02 |
| 1558794826 | Stephanie Noelle Francis | Marriage & Family Therapist | 4640 Admiralty Way, Suite 500, Marina Del Rey, CA 90292-6621 | 2013-08-09 |
| 1528308459 | Marina View Surgery Center | Clinic/Center | 4640 Admiralty Way, Suite 1002, Marina Del Rey, CA 90292-6621 | 2013-03-01 |
| 1104198514 | Mari Sian Davies | Clinical Neuropsychologist | 4640 Admiralty Way, Suite 500, Marina Del Rey, CA 90292-6621 | 2012-01-31 |
| 1639459654 | Farhad Sigari Md Facs PC | Otolaryngology | 4640 Admiralty Way, 718, Marina Del Rey, CA 90292-6621 | 2011-08-22 |
| 1508161167 | Michelle Z Wang Md PC | Anesthesiology | 4640 Admiralty Way, Marina Del Rey, CA 90292-6621 | 2011-01-12 |
| 1295037810 | Thomas Michael Hood | Dentist | 4640 Admiralty Way, Ste. 714, Marina Del Rey, CA 90292-6621 | 2010-12-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972142420 | Katy Kleinberg | Physical Therapist | 4820 Lincoln Blvd., Marina Del Rey, CA 90292 | 2020-01-02 |
| 1568028330 | Kylie Nakamine | Physical Therapist | 4820 Lincoln Bld, Marina Del Rey, CA 90292 | 2019-05-16 |
| 1033627807 | Kareema Nasouf | Social Worker | 578 Washington Blvd. #815, Marina Del Rey, CA 90292 | 2018-01-16 |
| 1861916611 | Jaqueline Berenice Higbee | Behavior Technician | 13428 Maxella Ave Apt 913, Marina Del Rey, CA 90292 | 2017-08-02 |
| 1063942696 | Luis Albert Japngie | Chiropractor | 13816 Bora Bora Way, A-109, Marina Del Rey, CA 90292 | 2017-06-15 |
| 1427509082 | Melissa Dowling | Nurse Anesthetist, Certified Registered | 4750 Lincoln Blvd Apt 477, Marina Del Rey, CA 90292 | 2016-10-19 |
| 1578932950 | Gratto Aquatic Rehab | Clinic/Center | 13160 Mindanao Way Ste. 308, Marina Del Ray, CA 90292 | 2015-09-16 |
| 1285018309 | Reed Chiropractic & Wellness Center A Professional Corporation | Chiropractor | 4207 Del Rey Ave., Marina Del Rey, CA 90292 | 2015-07-18 |
| 1083990725 | James J Kim | Pharmacist | 4009 Lincoln Blvd., Walgreens, Marina Del Rey, CA 90292 | 2011-10-26 |
| 1689957805 | Medbil, LLC | Anesthesiology | 1024 Oxford Ave., Marina Del Rey, CA 90292 | 2011-09-23 |
| Find all providers in zip 90292 | ||||
| Taxonomy Code | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114550498 | Hootan Zandifar Md Inc | Otolaryngology | 8920 Wilshire Blvd Ste 604, Beverly Hills, CA 90211-2006 | 2020-02-14 |
| 1548751183 | Farhad Ardesh Md Inc | Otolaryngology | 11620 Wilshire Blvd Ste 280, Los Angeles, CA 90025-1263 | 2018-05-18 |
| 1174943377 | Sunny Park Md, Inc | Otolaryngology | 901 Dover Dr Ste 126, Newport Beach, CA 92660-5546 | 2014-04-26 |
| 1154743987 | Keith Jay Wahl | Otolaryngology | 8735 Nottingham Pl, La Jolla, CA 92037-2129 | 2014-01-14 |
| 1295179570 | Ari Joseph Hyman | Otolaryngology | 16311 Ventura Blvd Ste 600, Encino, CA 91436-2134 | 2013-04-17 |
| 1710229893 | Zachary Calnan Fridirici | Otolaryngology | 2233 Post St Fl 3, San Francisco, CA 94115 | 2013-03-26 |
| 1376883975 | Su Mai | Otolaryngology | 13071 Brookhurst St Ste 150, Garden Grove, CA 92843-1024 | 2013-02-20 |
| 1710244892 | Meaghan Noud | Otolaryngology | 421 Post St Fl 14, San Francisco, CA 94102 | 2012-04-13 |
| 1508164500 | Dr. Sasha Maher D.o. | Otolaryngology | 10861 Cherry St Ste 106, Los Alamitos, CA 90720-5403 | 2011-03-01 |
| 1871804187 | Edwin E Breitenbach | Otolaryngology | 2601 Augusta, Tustin, CA 92782-1201 | 2010-07-01 |
| Find all providers with the same taxonomy | ||||
| City | MARINA DEL REY |
| Zip Code | 90292 |
Please comment or provide details below to improve the information on DR. BOUNMANY KYLE KEOJAMPA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.