Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 0101039955 | VA |
Y | 207N00000X | Dermatologist | C50041 | CA |
NPI | 1053414359 |
---|---|
Provider Name | Kenneth S. Hunter |
First Address | Salinas, CA 93901-4325 |
Second Address | Salinas, CA 93901-4325 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 19/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5900832 | (05) | VA |
G40038 | (02) | VA |