Provider Demographics
NPI:1437034071
Name:KADONO, LILY NYEIN (NP)
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:NYEIN
Last Name:KADONO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NYEIN
Other - Middle Name:CHAN
Other - Last Name:KADONO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16932 MERIT AVE
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-5613
Mailing Address - Country:US
Mailing Address - Phone:310-291-1931
Mailing Address - Fax:
Practice Address - Street 1:16932 MERIT AVE
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-5613
Practice Address - Country:US
Practice Address - Phone:310-291-1931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95035998363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology