Provider Demographics
NPI:1881890580
Name:LENORE S KAKITA MD INC
Entity type:Organization
Organization Name:LENORE S KAKITA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LENORE
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAKITA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-584-9933
Mailing Address - Street 1:225 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2717
Mailing Address - Country:US
Mailing Address - Phone:626-584-9933
Mailing Address - Fax:626-584-9333
Practice Address - Street 1:225 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2717
Practice Address - Country:US
Practice Address - Phone:626-584-9933
Practice Address - Fax:626-584-9333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11979207N00000X
CAA23000207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W11092Medicare ID - Type Unspecified
A23352Medicare UPIN