Provider Demographics
NPI:1831658152
Name:CHIRIBOGA, KALI
Entity Type:Individual
Prefix:
First Name:KALI
Middle Name:
Last Name:CHIRIBOGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 HIGHLAND AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2399
Mailing Address - Country:US
Mailing Address - Phone:513-584-7425
Mailing Address - Fax:513-584-7681
Practice Address - Street 1:3130 HIGHLAND AVE FL 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2399
Practice Address - Country:US
Practice Address - Phone:513-584-7425
Practice Address - Fax:513-584-7681
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-16
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program