Healthcare Provider Details

I. General information

NPI: 1285887406
Provider Name (Legal Business Name): KADENCE HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2008
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7554 TRADE ST
SAN DIEGO CA
92121-2412
US

IV. Provider business mailing address

10840 WALKER ST
CYPRESS CA
90630-5011
US

V. Phone/Fax

Practice location:
  • Phone: 858-563-6994
  • Fax: 858-569-6990
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number50017
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number103823
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number103823
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number50017
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number103823
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number50017
License Number StateCA

VIII. Authorized Official

Name: GREG D KAHN
Title or Position: CEO
Credential:
Phone: 714-220-0071