Provider Demographics
NPI:1770295867
Name:KIARA CL PALLIATIVE INC
Entity type:Organization
Organization Name:KIARA CL PALLIATIVE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:J
Authorized Official - Last Name:LIRA
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:949-735-2586
Mailing Address - Street 1:28120 PEACOCK RIDGE DR APT 608
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-3450
Mailing Address - Country:US
Mailing Address - Phone:949-735-2586
Mailing Address - Fax:
Practice Address - Street 1:28120 PEACOCK RIDGE DR APT 608
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-3450
Practice Address - Country:US
Practice Address - Phone:949-735-2586
Practice Address - Fax:949-649-7043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty