Kazim Agbaje
Individual provider Active NPI Medical Laboratory Technician · Spring Valley, CA
NPI 1154742963 · NPPES record last updated Dec 20, 2013
Key facts
- NPI
- 1154742963
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Laboratory Technician 246RM2200X
- License
- 04177814 (IL)
- Practice address
- 3111 Christy Way
Spring Valley, CA 91977-2629 - Phone
- (619) 764-0150
- NPI assigned
- Dec 20, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04177814 | IL | MD | Medical Laboratory Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Laboratory Technician | 246RM2200X | 04177814 | IL | Yes |
Addresses
Primary practice location
3111 Christy Way
Spring Valley, CA 91977-2629
Mailing address
3111 Christy Way
Spring Valley, CA 91977-2629
Phone (619) 764-0150
Other providers in Spring Valley, CA
- Jennifer Marie Farala Abreni
- Amira Abudiab
- Acclaim Health Care Consulting, Inc
- Veronica Diane Acosta
- Advantage Medical Group Apc
- Precious Destiny Agraz
- Jean Cassandra Blas Aguilar
- Maria V Agustin
- Veronique Ainsworth
- Layth Al Obaidi
All providers in Spring Valley, CA · Medical Laboratory Technician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.