Healthcare Provider Details

I. General information

NPI: 1669844486
Provider Name (Legal Business Name): KIIRO GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2015
Last Update Date: 10/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8939 S. SEPULVEDA SUITE 102
LOS ANGELES CA
90045
US

IV. Provider business mailing address

5042 WILSHIRE BLVD, #31630
LOS ANGELES CA
90036
US

V. Phone/Fax

Practice location:
  • Phone: 949-424-5840
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KUAN CHU
Title or Position: CEO
Credential:
Phone: 949-424-5840