Laura Elizabeth Kingkade | San Diego, CA • PECOS Search

Laura Elizabeth Kingkade

General Practice

Allopathic & Osteopathic Physicians

34800 Bob Wilson Dr, San Diego, CA 92134-1098

(619) 532-6400 (619) 869-9913

PECOS Enrollment

Based on the most recent information from CMS, provider Laura Elizabeth Kingkade does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1740975788
Provider Type
Individual
Full Name
Kingkade, Laura Elizabeth
Gender
Female

Sole Proprietor
Yes
Enumeration Date
4/6/2023
Last Updated
11/20/2025

Contact Information

Practice Location

34800 Bob Wilson Dr, San Diego, CA 92134-1098

Unlisted Fax

Mailing Location

781 Vada St Unit 3, Chula Vista, CA 91911-6454

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208D00000X Primary	Description General Practice Allopathic & Osteopathic Physicians	License 0101286854 Virginia