Kourtney Kate Vidal, LVN is a
Licensed Vocational Nurse based in Playa Del Rey, California. Kourtney Kate Vidal is licensed to practice in California (license number VN726574) and her current practice location is
7742 Paseo Del Rey Apt 6, Playa Del Rey, California. She can be reached at her office (for appointments etc.) via phone at
(562) 552-7646.
NPI number for Kourtney Kate Vidal is 1184303356 and her current mailing address is 1601 N Sepulveda Blvd # 605, Manhattan Beach, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1184303356.
Provider's Profile
Full Name | Kourtney Kate Vidal |
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Gender | Female |
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Speciality | Licensed Vocational Nurse |
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Location | 7742 Paseo Del Rey Apt 6, Playa Del Rey, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1184303356
- Provider Enumeration Date: 07/14/2023
- Last Update Date: 07/14/2023
Medical Identifiers
Medical identifiers for Kourtney Kate Vidal such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1184303356 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164X00000X | Licensed Vocational Nurse | VN726574 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kourtney Kate Vidal is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kourtney Kate Vidal, LVN 1601 N Sepulveda Blvd # 605, Manhattan Beach, CA 90266-5111 Ph: (424) 542-1280 | Kourtney Kate Vidal, LVN 7742 Paseo Del Rey Apt 6, Playa Del Rey, CA 90293-8343 Ph: (562) 552-7646 |
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