Healthcare Provider Details

I. General information

NPI: 1225605025
Provider Name (Legal Business Name): DENNIS KAMAKIA REGISTERED NURSE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13061 MILLER AVE
NORWALK CA
90650-3342
US

IV. Provider business mailing address

13061 MILLER AVE
NORWALK CA
90650-3342
US

V. Phone/Fax

Practice location:
  • Phone: 562-964-3902
  • Fax:
Mailing address:
  • Phone: 562-964-3902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95024492
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberNP95013688
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: