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NPI Code Detail

MEDICARE: JEAN ELIZABETH KIGOZI RD

MEDICARE: JEAN ELIZABETH KIGOZI RD
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
1133V00000XRegistered Dietitian967976CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528235520
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEAN ELIZABETH KIGOZI RD
Provider Business Mailing Address
First Line : 818 W ALONDRA BLVD
Second Line :
City : COMPTON
State : CA
Zip : 90220-3500
Country : US
Telephone Number : 310-531-1337
Fax Number :
Provider Business Practice Location Address
First Line : 818 W ALONDRA BLVD
Second Line :
City : COMPTON
State : CA
Zip : 90220-3500
Country : US
Telephone Number : 310-537-1337
Fax Number : 310-764-1011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2008
Last Update Date : 08/26/2008

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Directions to “ JEAN ELIZABETH KIGOZI RD” Practice Location

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