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Organization
KP1 AND 2 INC
Active
Organization
KP1 AND 2 INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI LABRECQUE (ACCTS MGR)
(702) 453-3799
Entity
Organization
Contact information
Practice address
444 BRUCE ST, YREKA, CA 96097-3450
(530) 842-4121
Mailing address
PO BOX 16102, SAN DIEGO, CA 92176-6102
(702) 453-3799
(702) 453-5741
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
A70333
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A70333
CA LIC
CA
Enumeration date
09/07/2012
Last updated
01/20/2015
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