Healthcare Provider Details

I. General information

NPI: 1245956234
Provider Name (Legal Business Name): KAAKI WOMENS HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4646 BROCKTON AVE STE 302-5
RIVERSIDE CA
92506-0102
US

IV. Provider business mailing address

20409 YORBA LINDA BLVD STE K2-305
YORBA LINDA CA
92886-3042
US

V. Phone/Fax

Practice location:
  • Phone: 951-900-1201
  • Fax:
Mailing address:
  • Phone: 319-830-8969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number
License Number State

VIII. Authorized Official

Name: BILAL R. KAAKI
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 319-830-8969