MEDICARE: KEYONIA K PARAMORE

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	224P00000X	Prosthetist		CA

General Provider Information

NPI Number	:	1154895944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEYONIA K PARAMORE

Provider Business Mailing Address
First Line	:	1360 REDONDO AVE APT 103
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-2880
Country	:	US
Telephone Number	:	562-480-7264
Fax Number	:

Provider Business Practice Location Address
First Line	:	735 W PACIFIC COAST HWY
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-5240
Country	:	US
Telephone Number	:	562-480-7264
Fax Number	:

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

Provider Enumeration Date	:	01/15/2019
Last Update Date	:	01/15/2019

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Directions to “ KEYONIA K PARAMORE ” Practice Location

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