Healthcare Provider Details

I. General information

NPI: 1932026457
Provider Name (Legal Business Name): DML-KKC COMPANIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 S 2ND AVE
BARSTOW CA
92311-2891
US

IV. Provider business mailing address

425 S 2ND AVE
BARSTOW CA
92311-2891
US

V. Phone/Fax

Practice location:
  • Phone: 702-213-2074
  • Fax:
Mailing address:
  • Phone: 702-213-2074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: DAVID LEE
Title or Position: VP
Credential:
Phone: 800-909-1997