MEDICARE: KENDALL L FOX

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	163W00000X	Registered Nurse	95197088	CA

General Provider Information

NPI Number	:	1730013913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDALL L FOX

Provider Business Mailing Address
First Line	:	76318 NOTRE DAME DR
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-1769
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3554 FIR ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92104-5708
Country	:	US
Telephone Number	:	508-742-7194
Fax Number	:

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

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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Directions to “ KENDALL L FOX ” Practice Location

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