MEDICARE: KAOBIMDI C OSAMOR

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	163WM0705X	Medical-Surgical Registered Nurse	833049	CA

General Provider Information

NPI Number	:	1902610041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAOBIMDI C OSAMOR

Provider Business Mailing Address
First Line	:	8241 MORSE AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-1056
Country	:	US
Telephone Number	:	818-669-2658
Fax Number	:

Provider Business Practice Location Address
First Line	:	8241 MORSE AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-1056
Country	:	US
Telephone Number	:	818-669-2658
Fax Number	:

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

Provider Enumeration Date	:	02/06/2025
Last Update Date	:	02/06/2025

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Directions to “ KAOBIMDI C OSAMOR ” Practice Location

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