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General NPI Number Information
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NPI Number | 1396605432
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Entity Type | Organization
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Legal Business Name | KC MEDICAL MANAGEMENT
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Dates
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Enumeration Date | 11/12/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 18464 W SUPERIOR AVE
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City | GOODYEAR
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State | AZ
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Zip | 85338-7605
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Country | US
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Telephone | 805-419-4234
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Fax | 805-383-6646
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Provider Business Mailing Address
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Address Line | 18464 W SUPERIOR AVE
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City | GOODYEAR
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State | AZ
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Zip | 85338-7605
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Country | US
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Telephone | 805-419-4234
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Fax | 805-383-6646
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Authorized Official
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Title or Position | CEO
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Name | KAREY COLLINS
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Credential |
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Telephone | 805-419-4234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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