Provider Demographics
NPI:1396414561
Name:KANSIDOR HEALTHCARE INC
Entity Type:Organization
Organization Name:KANSIDOR HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:INGA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOLLUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-215-3198
Mailing Address - Street 1:3151 CAHUENGA BLVD W STE 305
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-1768
Mailing Address - Country:US
Mailing Address - Phone:747-215-3198
Mailing Address - Fax:
Practice Address - Street 1:3151 CAHUENGA BLVD W STE 305
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-1768
Practice Address - Country:US
Practice Address - Phone:747-215-3198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based