Provider Demographics
NPI:1609041581
Name:LOC, KIET (MD)
Entity Type:Individual
Prefix:DR
First Name:KIET
Middle Name:
Last Name:LOC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24012 CALLE DE LA PLATA STE 150
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3632
Mailing Address - Country:US
Mailing Address - Phone:949-837-1130
Mailing Address - Fax:949-587-1068
Practice Address - Street 1:24012 CALLE DE LA PLATA STE 150
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3632
Practice Address - Country:US
Practice Address - Phone:858-335-4662
Practice Address - Fax:949-587-1068
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1193382084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology