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General NPI Number Information
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NPI Number | 1003183237
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Entity Type | Organization
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Legal Business Name | KANDDID HEALTH CARE INC
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Dates
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Enumeration Date | 11/16/2011
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Last Update Date | 12/27/2012
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Provider Practice Location Address
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Address Line | 9161 SIERRA AVE SUITE 200
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City | FONTANA
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State | CA
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Zip | 92335-4729
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Country | US
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Telephone | 909-574-6000
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Fax | 909-574-6001
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Provider Business Mailing Address
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Address Line | 9161 SIERRA AVE SUITE 200
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City | FONTANA
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State | CA
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Zip | 92335-4729
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Country | US
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Telephone | 909-574-6000
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Fax | 909-574-6001
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Authorized Official
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Title or Position | DIRECTOR OF PATIENT CARE SERVICES
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Name | MRS. NONYELUM CORDELIA OBI
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Credential | RN
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Telephone | 909-574-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 240000709
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License Number State | CA
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