MEDICARE: KKB HEALTH SOLUTIONS

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1407505878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KKB HEALTH SOLUTIONS

Provider Business Mailing Address
First Line	:	4029 WESTERLY PL STE 109A
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2329
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4029 WESTERLY PL STE 109A
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2329
Country	:	US
Telephone Number	:	561-860-6551
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	KATIE MURPHY
Credential	:
Telephone Number	:	561-860-6551

Provider Enumeration Date	:	03/22/2022
Last Update Date	:	03/22/2022

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Directions to “KKB HEALTH SOLUTIONS ” Practice Location

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