Kenneth R Boren
Nephrologist
4040 E Mclellan Rd Unit 11
Mesa
, Arizona 85205-3105
Kenneth R Boren
Nephrologist
4040 E Mclellan Rd Unit 11
Mesa
, Arizona 85205-3105
(480) 229-2829
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About
Features
Specialties
- Nephrologist
Languages spoken
- English
Location
First Address
- Kenneth R Boren
- 4040 E Mclellan Rd Unit 11
- Mesa, AZ
- Zip : 85205-3105
- Phone : (480) 229-2829
Second Address
- Kenneth R Boren
- 4040 E Mclellan Rd Unit 11
- Mesa, AZ
- Zip : 85205-3105
- Phone : (480) 229-2829
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RN0300X | Nephrologist | 12288 | AZ |
National Provider Identifier
| NPI | 1043205511 |
|---|---|
| Provider Name | Kenneth R Boren |
| First Address | Mesa, AZ 85205-3105 |
| Second Address | Mesa, AZ 85205-3105 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/09/2005 |
| Last Update Date | 11/08/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 226911 | (05) | AZ |
| D43720 | (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.