Healthcare Provider Details

I. General information

NPI: 1629181839
Provider Name (Legal Business Name): KENDRA D ARMOUR PA-C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15080 7TH ST STE 6
VICTORVILLE CA
92395-3865
US

IV. Provider business mailing address

15080 7TH ST STE 6
VICTORVILLE CA
92395-3865
US

V. Phone/Fax

Practice location:
  • Phone: 760-243-7330
  • Fax: 760-243-6900
Mailing address:
  • Phone: 760-243-7330
  • Fax: 760-243-6900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA13441
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: