Basic Information
| Provider Information | |||||||||
| NPI: | 1629344791 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OZMON | ||||||||
| FirstName: | KIMBERLY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 949 EUCLID AVE | ||||||||
| Address2: | |||||||||
| City: | BEAUMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922231847 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095343850 | ||||||||
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| Practice Location | |||||||||
| Address1: | 41990 COOK ST BLDG F | ||||||||
| Address2: | |||||||||
| City: | PALM DESERT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922116100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603415570 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2012 | ||||||||
| LastUpdateDate: | 03/22/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 257564 | CA | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.