Provider Demographics
NPI:1962623017
Name:KINSKAY GROUP INC
Entity type:Organization
Organization Name:KINSKAY GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUWAKEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:KAYODEAKINSILO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-533-5405
Mailing Address - Street 1:5633 TEMPE DR
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552-6029
Mailing Address - Country:US
Mailing Address - Phone:661-533-5404
Mailing Address - Fax:
Practice Address - Street 1:5633 TEMPE DR
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93552-6029
Practice Address - Country:US
Practice Address - Phone:661-533-5404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47261332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03439FMedicaid
CA6107980001Medicare NSC