Provider Demographics
NPI:1770307274
Name:KAISER MEDICAL PARTNERS LLC
Entity type:Organization
Organization Name:KAISER MEDICAL PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:UNITED STATES CORPOR
Authorized Official - Middle Name:
Authorized Official - Last Name:INC.
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-587-6482
Mailing Address - Street 1:3939 US HIGHWAY 80 E STE 236F
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-3359
Mailing Address - Country:US
Mailing Address - Phone:800-773-0888
Mailing Address - Fax:
Practice Address - Street 1:3939 US HIGHWAY 80 E STE 236F
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-3359
Practice Address - Country:US
Practice Address - Phone:214-587-6482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-12
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health