Healthcare Provider Details

I. General information

NPI: 1851673610
Provider Name (Legal Business Name): KAYE LIM ELAMPARO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2011
Last Update Date: 04/23/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9834 GENESEE AVE STE 310
LA JOLLA CA
92037-1221
US

IV. Provider business mailing address

PO BOX 51449
LOS ANGELES CA
90051-6303
US

V. Phone/Fax

Practice location:
  • Phone: 858-909-9033
  • Fax: 858-815-6820
Mailing address:
  • Phone: 858-309-6585
  • Fax: 858-309-6593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number20795
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number3604
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number653081
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: