Healthcare Provider Details

I. General information

NPI: 1831008648
Provider Name (Legal Business Name): KILL REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45604 65TH ST E
LANCASTER CA
93535-8301
US

IV. Provider business mailing address

45604 65TH ST E
LANCASTER CA
93535-8301
US

V. Phone/Fax

Practice location:
  • Phone: 661-494-4319
  • Fax:
Mailing address:
  • Phone: 661-494-4319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MELODY CABRALES
Title or Position: BACHELOR
Credential: MD
Phone: 661-494-4319