Provider Demographics
NPI:1851673610
Name:ELAMPARO, KAYE LIM (NP)
Entity Type:Individual
Prefix:
First Name:KAYE
Middle Name:LIM
Last Name:ELAMPARO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 51449
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-6303
Mailing Address - Country:US
Mailing Address - Phone:858-309-6585
Mailing Address - Fax:858-309-6593
Practice Address - Street 1:9834 GENESEE AVE STE 310
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1221
Practice Address - Country:US
Practice Address - Phone:858-909-9033
Practice Address - Fax:858-815-6820
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA653081163W00000X
CA3604364S00000X
CA20795363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20795OtherNURSE PRACTITIONER LICENSE
CA3604OtherCLINICAL NURSE LICENSE
CA653081OtherRN LICENSE