Healthcare Provider Details

I. General information

NPI: 1134062177
Provider Name (Legal Business Name): KABAFUSION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 MEDIA CENTER DR STE 150, BLDG 6
LOS ANGELES CA
90065-1748
US

IV. Provider business mailing address

17777 CENTER COURT DR N STE 550
CERRITOS CA
90703-9337
US

V. Phone/Fax

Practice location:
  • Phone: 877-361-5316
  • Fax: 323-244-2780
Mailing address:
  • Phone: 800-435-3020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. TINA BENKENDORFER
Title or Position: CHIEF OPERATING OFFICER
Credential: PHARM. D.
Phone: 800-435-3020