Kimberly Hagen Tillar, R.N.

Primary specialty

Oncology Registered NurseTaxonomy code 163WX0200X

License

375548 Issued in CA

Practice address

2021 Santa Monica Blvd
Suit 400E
Santa Monica, CA 90404-2208

Phone

(310) 453-5654

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104944420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7819 BLERIOT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900452904",
            "telephone_number": "310-649-3239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD",
            "address_2": "SUIT 400E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042208",
            "telephone_number": "310-453-5654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLAR",
        "first_name": "KIMBERLY",
        "middle_name": "HAGEN",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "CA",
            "license": "375548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Tien, PA
• Elizabeth Tieu
• Tiffany B Grunwald, MD, Inc.
• Kelsey Dawn Tiffany
• Elizabeth A Tighe
• Candice Bianca Tilles, M.D.
• Timothy Davis, MD
• Timothy T Davis M.D. a Professional Corporation
• Timothy T. Davis M.D. a Professional Corporation
• Tina Bahador, P.HD., a Professional Psychology Corporation

• Oncology Registered Nurse in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Oncology Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.