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NPI Code Detail

MEDICARE: KIDS FIRST FOUNDATION

MEDICARE: KIDS FIRST FOUNDATION
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
1251S00000XCommunity/Behavioral Health Agency336401070CA

General Provider Information

NPI Number : 1093955304
Entity Type Code : Organization
Provider Name (Legal Business Name) : KIDS FIRST FOUNDATION
Provider Business Mailing Address
First Line : 993C S SANTA FE AVE STE 50
Second Line :
City : VISTA
State : CA
Zip : 92083-6910
Country : US
Telephone Number : 760-631-7550
Fax Number : 760-630-5248
Provider Business Practice Location Address
First Line : 10001 COUNTY FARM RD
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-3507
Country : US
Telephone Number : 951-343-2536
Fax Number : 951-729-3309
Authorized Official
Title or Position : CEO
Name : MR. IHAB SHAWAHI
Credential :
Telephone Number : 760-631-7550
Provider Enumeration Date : 02/26/2009
Last Update Date : 03/12/2010

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Directions to “KIDS FIRST FOUNDATION ” Practice Location

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