Provider Demographics
NPI:1578732491
Name:PADMINI KELLY-SKINNER
Entity Type:Organization
Organization Name:PADMINI KELLY-SKINNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:PADMINI
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY-SKINNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-420-0244
Mailing Address - Street 1:250 E MANCHESTER LN
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-4168
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:250 E MANCHESTER LN
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-4168
Practice Address - Country:US
Practice Address - Phone:909-420-0244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA629768282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital