Kenneth P. Lyons
Nuclear Medicine Specialist
20162 Sw Birch St Suite 150
Newport Beach
, California 92660-0787
Kenneth P. Lyons
Nuclear Medicine Specialist
20162 Sw Birch St Suite 150
Newport Beach
, California 92660-0787
(949) 221-1704
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About
Features
Specialties
- Nuclear Medicine Specialist
Languages spoken
- English
Location
First Address
- Kenneth P. Lyons
- 20162 Sw Birch St Suite 150
- Newport Beach, CA
- Zip : 92660-0787
- Fax : (949) 221-1704
- Phone : (949) 221-1700
Second Address
- Kenneth P. Lyons
- 20162 Sw Birch St Suite 150
- Newport Beach, CA
- Zip : 92660-0787
- Fax : (949) 221-1704
- Phone : (949) 221-1700
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207U00000X | Nuclear Medicine Specialist | G12843 | CA |
National Provider Identifier
| NPI | 1770523391 |
|---|---|
| Provider Name | Kenneth P. Lyons |
| First Address | Newport Beach, CA 92660-0787 |
| Second Address | Newport Beach, CA 92660-0787 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/06/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00G128430 | (05) | CA |
| 00G128430 | BLUE SHIELD (01) | CA |
| A38793 | (02) |
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.