Individual
KUDITSHINI KAKESE MUKENDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IDC
Contact information
Practice address
8829 SPECTRUM CENTER BLVD, APT 3111, SAN DIEGO, CA 92123-1457
(843) 228-2111
Mailing address
283 BLVD DE FRANCE, PARRIS ISLAND, SC 29905
(843) 228-2111
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710/1002X
IDC
—
Enumeration date
05/01/2013
Last updated
05/01/2013
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