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General NPI Number Information
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NPI Number | 1750364345
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Entity Type | Organization
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Legal Business Name | KAN-DI-KI LLC
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 12612 RAYMER ST
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605-4307
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Country | US
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Telephone | 818-549-1880
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Fax |
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Provider Business Mailing Address
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Address Line | 930 RIDGEBROOK RD FL 3
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City | SPARKS
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State | MD
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Zip | 21152-9481
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Country | US
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Telephone | 800-786-8015
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Fax | 410-472-1754
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL/CFO
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Name | BRIAN C CUOMO
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Credential |
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Telephone | 800-786-8015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 205582
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number | 043518
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License Number State | CA
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