Provider Demographics
NPI:1225605025
Name:KAMAKIA, DENNIS (REGISTERED NURSE)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:
Last Name:KAMAKIA
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13061 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-3342
Mailing Address - Country:US
Mailing Address - Phone:562-964-3902
Mailing Address - Fax:
Practice Address - Street 1:11149 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90303-2338
Practice Address - Country:US
Practice Address - Phone:310-677-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-09
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95013688207Q00000X
CA95024492163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine