Search › California › 164X00000X
Kelvin Clarence Derrada
NPI 1295242899 · on the registry since 2018 · sole proprietor
Practice
- Address
- 13405 Brookwood Way
Lathrop, CA 95330 - Phone
- (209) 982-9368
Registry record
- Primary taxonomy
- 164X00000X
164X00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-01-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California