Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G51775 | CA |
Y | 208600000X | Surgeon | G51775 | CA |
N | 2082S0105X | Plastic Hand Surgeon | G51775 | CA |
NPI | 1962437798 |
---|---|
Provider Name | Dr. Brian M Kinney |
First Address | Beverly Hills, CA 90212-1800 |
Second Address | Beverly Hills, CA 90212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 17/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1962437798 | MEDICARE NPI NUMBER (01) | CA |
C36120 | (02) | CA |