Provider Demographics
NPI:1467135608
Name:DAKTARI TELEMEDICINE LLC
Entity Type:Organization
Organization Name:DAKTARI TELEMEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOASH
Authorized Official - Middle Name:KIPKURUI
Authorized Official - Last Name:KEMEI
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:209-233-7944
Mailing Address - Street 1:2354 PACHECO DR
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-5636
Mailing Address - Country:US
Mailing Address - Phone:209-233-7944
Mailing Address - Fax:
Practice Address - Street 1:2354 PACHECO DR
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-5636
Practice Address - Country:US
Practice Address - Phone:209-233-7944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty