Healthcare Provider Details

I. General information

NPI: 1861375198
Provider Name (Legal Business Name): KAMEL SADR RESPIRATORY CARE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2447 PACIFIC COAST HWY STE 200
HERMOSA BEACH CA
90254-2714
US

IV. Provider business mailing address

12450 GULLIVER RD
SPRING HILL FL
34609-4144
US

V. Phone/Fax

Practice location:
  • Phone: 323-639-5436
  • Fax:
Mailing address:
  • Phone: 352-232-1555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2278C0205X
TaxonomyCritical Care Certified Respiratory Therapist
License Number194011983
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2278C0205X
TaxonomyCritical Care Certified Respiratory Therapist
License Number5833-28
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code2278C0205X
TaxonomyCritical Care Certified Respiratory Therapist
License Number122.0134399
License Number StateVT
# 4
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License NumberRT11718
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: