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General NPI Number Information
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NPI Number | 1982094314
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Entity Type | Individual
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Provider Name | MS. NYDIA SANCHEZ KIMP
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Gender | Female
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 15530 TUBA ST
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City | MISSION HILLS
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State | CA
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Zip | 91345-2617
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Country | US
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Telephone | 818-471-8488
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Fax |
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Provider Business Mailing Address
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Address Line | 15530 TUBA ST
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City | MISSION HILLS
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State | CA
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Zip | 91345-2617
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Country | US
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Telephone | 818-471-8488
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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 | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | A1529271
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | B6746157
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License Number State | CA
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