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General NPI Number Information
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NPI Number | 1184973836
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Entity Type | Organization
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Legal Business Name | KP1 AND 2 INC
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Dates
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Enumeration Date | 09/07/2012
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Last Update Date | 01/20/2015
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Provider Practice Location Address
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Address Line | 444 BRUCE ST
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City | YREKA
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State | CA
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Zip | 96097-3450
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Country | US
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Telephone | 530-842-4121
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16102
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City | SAN DIEGO
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State | CA
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Zip | 92176-6102
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Country | US
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Telephone | 702-453-3799
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Fax | 702-453-5741
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Authorized Official
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Title or Position | ACCTS MGR
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Name | LORI LABRECQUE
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Credential |
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Telephone | 702-453-3799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A70333
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License Number State | CA
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