Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | 036121352 | IL |
Y | 2086S0120X | Pediatric Surgery | A84875 | CA |
NPI | 1073777934 |
---|---|
Provider Name | Dr. Robert Carr Kanard |
First Address | San Clemente, CA 92674-1359 |
Second Address | Santa Barbara, CA 93105-4353 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 09/11/2021 |