MEDICARE: KS CARE LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1144061011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KS CARE LLC

Provider Business Mailing Address
First Line	:	3737 CAMINO DEL RIO S STE 110
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-4007
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3737 CAMINO DEL RIO S STE 110
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-4007
Country	:	US
Telephone Number	:	858-208-3787
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KONSTANTIN SERBIN
Credential	:
Telephone Number	:	619-549-7900

Provider Enumeration Date	:	06/04/2024
Last Update Date	:	06/04/2024

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Directions to “KS CARE LLC ” Practice Location

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