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General NPI Number Information
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NPI Number | 1740196492
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Entity Type | Individual
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Provider Name | KEVIN MOLEDOR PARAMEDIC
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Gender | Male
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Dates
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Enumeration Date | 08/21/2026
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 86400 LIGHTNING ST HNGR D
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City | THERMAL
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State | CA
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Zip | 92274-9576
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Country | US
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Telephone | 657-428-9428
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Fax |
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Provider Business Mailing Address
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Address Line | 5130 E HENLEY PL UNIT B
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City | VILLA PARK
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State | CA
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Zip | 92867-1655
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Country | US
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Telephone |
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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 | 146L00000X
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Taxonomy Name | Paramedic
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License Number | P34650
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License Number State | CA
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