Provider Demographics
NPI:1235889825
Name:FRISOLI, KENDALL NICOLE (MD)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:NICOLE
Last Name:FRISOLI
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 1:5700 E 2ND STREET
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803
Mailing Address - Country:US
Mailing Address - Phone:657-241-4050
Mailing Address - Fax:657-276-4738
Practice Address - Street 1:5700 E 2ND STREET
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803
Practice Address - Country:US
Practice Address - Phone:657-241-4050
Practice Address - Fax:657-276-4738
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA191084207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine