Provider Demographics
NPI:1891013462
Name:KIPPS, KRISTEN ANNA (MD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ANNA
Last Name:KIPPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1250 16TH ST
Mailing Address - Street 2:SUITE 2304
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1249
Mailing Address - Country:US
Mailing Address - Phone:310-319-4698
Mailing Address - Fax:310-319-4908
Practice Address - Street 1:1250 16TH ST
Practice Address - Street 2:SUITE 2304
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1249
Practice Address - Country:US
Practice Address - Phone:310-319-4698
Practice Address - Fax:310-319-4908
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA124562208M00000X, 207R00000X
NY268707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine