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General NPI Number Information
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NPI Number | 1689066318
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Entity Type | Individual
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Provider Name | KIMBERLY ADAMS
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Gender | Female
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Dates
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Enumeration Date | 03/04/2015
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Last Update Date | 03/04/2015
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Provider Practice Location Address
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Address Line | 2930 W IMPERIAL HWY STE 200Q
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City | INGLEWOOD
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State | CA
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Zip | 90303-3142
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Country | US
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Telephone | 323-524-0041
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Fax | 877-293-8397
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Provider Business Mailing Address
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Address Line | 28480 FOREST OAKS WAY
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City | MORENO VALLEY
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State | CA
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Zip | 92555-6319
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Country | US
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Telephone | 323-524-0041
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Fax | 877-293-8397
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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 | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State |
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