MEDICARE: DR.KAY HEALS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	AC9997	CA

General Provider Information

NPI Number	:	1013158856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR.KAY HEALS INC.

Provider Business Mailing Address
First Line	:	5007 RIGOLETTO ST
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2819
Country	:	US
Telephone Number	:	818-854-6377
Fax Number	:	818-366-7078

Provider Business Practice Location Address
First Line	:	5007 RIGOLETTO ST
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2819
Country	:	US
Telephone Number	:	818-854-6377
Fax Number	:	818-366-7078

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KAY J KIM
Credential	:	AC
Telephone Number	:	818-854-6377

Provider Enumeration Date	:	03/06/2009
Last Update Date	:	03/06/2009

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