Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0127X | Trauma Surgeon | G66159 | CA |
NPI | 1477564474 |
---|---|
Provider Name | Dr. Todd A Kanen |
First Address | Santa Barbara, CA 93111-3331 |
Second Address | Santa Barbara, CA 93111-3331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 22/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F02074 | (02) | CA |