Organization
CAREMORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OFELIA KIEDPOOL (NURSE PRACTITIONER)
(562) 741-4470
Entity
Organization
Contact information
Practice address
12900 PARK PLAZA DR STE 150, CERRITOS, CA 90703-9329
(562) 741-4470
Mailing address
12900 PARK PLAZA DR STE 150, CERRITOS, CA 90703-9329
(562) 741-4470
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
20892
CA
261QM2500X
Medical Specialty Clinic/Center
Primary
20892
CA
Other
Enumeration date
02/14/2012
Last updated
02/14/2012
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