Organization
KAISER PERMANENTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA RENEE DAVIS RN (RN)
(402) 318-4165
Entity
Organization
Contact information
Practice address
13748 HEATHERWOOD DR, EASTVALE, CA 92880-0713
(402) 318-4165
Mailing address
13748 HEATHERWOOD DR, EASTVALE, CA 92880-0713
(402) 318-4165
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
RN.0182309
CO
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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