Active NPI
Kyle Justin Difulvio, MA
- Student in an Organized Health Care Education/Training Program
- Santa Monica, CA
National Provider Identifier
1699205641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1527 4TH St
Santa Monica, CA 90401-2358 - Phone
- (310) 394-9871
- NPI assigned
- Jun 13, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1527 4TH St
Santa Monica, CA 90401-2358
Mailing address
1527 4TH St
Santa Monica, CA 90401-2358
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497830400000",
"number": "1699205641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1527 4TH ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904012358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1527 4TH ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904012358",
"telephone_number": "310-394-9871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIFULVIO",
"first_name": "KYLE",
"middle_name": "JUSTIN",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-13",
"last_updated": "2017-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
- Brian Dickey, MD
- Melissa Ann Dickey, FNP
- Robert Curtis Dickey, O.D.
- Cynthia P Diep, D.D.S.
- Holly Dieu, M.D.
- Rachel Lynne Digangi, DC
- Digestive Health Associates
- Digestive Health Associates of Southern California
- Digestive Health Associates of Southern California
- Digestive Health Associates of Southern California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.