MEDICARE: DARYN KALMUS BCBA

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	103K00000X	Behavior Analyst	1-08-4215

General Provider Information

NPI Number	:	1114290772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARYN KALMUS BCBA

Provider Business Mailing Address
First Line	:	4221 WILSHIRE BLVD
Second Line	:	SUITE 300A
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-3512
Country	:	US
Telephone Number	:	323-866-1880
Fax Number	:	323-866-1881

Provider Business Practice Location Address
First Line	:	4221 WILSHIRE BLVD
Second Line	:	SUITE 300A
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-3512
Country	:	US
Telephone Number	:	323-866-1880
Fax Number	:	323-866-1881

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2012
Last Update Date	:	03/08/2017

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