Healthcare Provider Details

I. General information

NPI: 1790491850
Provider Name (Legal Business Name): KAKAL PULMONARY AND CRITICAL CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 WOODLAKE AVE STE 290
WEST HILLS CA
91307-1490
US

IV. Provider business mailing address

PO BOX 77790
CORONA CA
92877-0126
US

V. Phone/Fax

Practice location:
  • Phone: 747-236-1666
  • Fax: 747-200-2572
Mailing address:
  • Phone: 800-626-2468
  • Fax: 951-272-1598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: KHADIR KAKAL
Title or Position: PRESIDENT/PHYSICIAN
Credential: MD
Phone: 516-884-0700