MEDICARE: KAN-DI-KI 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	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	043518	CA
2	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

General Provider Information

NPI Number	:	1225290174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAN-DI-KI LLC

Provider Business Mailing Address
First Line	:	215 SCHILLING CIR STE 114
Second Line	:
City	:	HUNT VALLEY
State	:	MD
Zip	:	21031-1113
Country	:	US
Telephone Number	:	800-786-8015
Fax Number	:

Provider Business Practice Location Address
First Line	:	12612 RAYMER ST
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-4307
Country	:	US
Telephone Number	:	800-786-8015
Fax Number	:	443-842-7264

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL/CFO
Name	:	BRIAN C CUOMO
Credential	:
Telephone Number	:	800-786-8015

Provider Enumeration Date	:	07/01/2008
Last Update Date	:	03/11/2026

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Directions to “KAN-DI-KI LLC ” Practice Location

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