MEDICARE: KMJW LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1477489219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KMJW LLC

Provider Business Mailing Address
First Line	:	1825 HAMNER AVE STE F
Second Line	:
City	:	NORCO
State	:	CA
Zip	:	92860-2965
Country	:	US
Telephone Number	:	714-330-0272
Fax Number	:

Provider Business Practice Location Address
First Line	:	1825 HAMNER AVE STE F
Second Line	:
City	:	NORCO
State	:	CA
Zip	:	92860-2965
Country	:	US
Telephone Number	:	714-330-0272
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WAFA MEKAIL
Credential	:
Telephone Number	:	714-330-0272

Provider Enumeration Date	:	06/19/2026
Last Update Date	:	06/19/2026

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Directions to “KMJW LLC ” Practice Location

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