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General NPI Number Information
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NPI Number | 1588718811
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Entity Type | Individual
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Provider Name | STANISLAUS KINOTA M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4450 W CENTURY BLVD
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City | INGLEWOOD
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State | CA
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Zip | 90304-1504
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Country | US
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Telephone | 310-671-0555
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Fax | 310-674-5292
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Provider Business Mailing Address
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Address Line | 4727 W 147TH ST APT 218B
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City | LAWNDALE
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State | CA
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Zip | 90260-1310
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Country | US
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Telephone | 310-978-2863
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | G73647
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License Number State | CA
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