Kenneth Glen Wys
Anesthesiologist Critical Care Medicine
47111 Monroe St
Indio
, California 92201-6739
Kenneth Glen Wys
Anesthesiologist Critical Care Medicine
47111 Monroe St
Indio
, California 92201-6739
(760) 775-8017
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About
Features
Specialties
- Anesthesiologist
- Critical Care Medicine
Languages spoken
- English
Location
First Address
- Kenneth Glen Wys
- 47111 Monroe St
- Indio, CA
- Zip : 92201-6739
- Fax : (760) 775-8017
- Phone : (760) 347-6191
Second Address
- Kenneth Glen Wys
- 47111 Monroe St
- Indio, CA
- Zip : 92201-6739
- Fax : (760) 775-8017
- Phone : (760) 347-6191
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207L00000X | Anesthesiologist | A64344 | CA |
| Y | 207RC0200X | Critical Care Medicine | A64344 | CA |
National Provider Identifier
| NPI | 1003929712 |
|---|---|
| Provider Name | Kenneth Glen Wys |
| First Address | Indio, CA 92201-6739 |
| Second Address | Indio, CA 92201-6739 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/08/2006 |
| Last Update Date | 28/01/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.