Provider Demographics
NPI:1316597230
Name:K-CLEAR NURSING INC
Entity Type:Organization
Organization Name:K-CLEAR NURSING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KLAR
Authorized Official - Middle Name:FULGENTES
Authorized Official - Last Name:PASILABAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:805-813-7979
Mailing Address - Street 1:1822 SPRINGGATE LN UNIT G.
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065
Mailing Address - Country:US
Mailing Address - Phone:805-813-7979
Mailing Address - Fax:
Practice Address - Street 1:1822 SPRINGGATE LN UNIT G.
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065
Practice Address - Country:US
Practice Address - Phone:805-813-7979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-12
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty