Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A91099 | CA |
NPI | 1033193669 |
---|---|
Provider Name | Dr. Kevin Thomas Brumund |
First Address | San Diego, CA 92103-8895 |
Second Address | San Diego, CA 92103-8895 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 08/07/2007 |