Provider Demographics
NPI:1982232054
Name:K4 INNOVATIONS LLC
Entity Type:Organization
Organization Name:K4 INNOVATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:949-290-9950
Mailing Address - Street 1:4034 CALLE LISA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-4509
Mailing Address - Country:US
Mailing Address - Phone:949-290-9950
Mailing Address - Fax:
Practice Address - Street 1:4034 CALLE LISA
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-4509
Practice Address - Country:US
Practice Address - Phone:949-290-9950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies