Ballentine, Kenneth H
Ballentine, Kenneth H is an individual health care provider with primary practice located at 5275 Prospect Rd , San Jose CA 95129-5031. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ballentine, Kenneth H can be contacted via phone (408) 255-0576.Contact Information
Primary practice address
5275 Prospect Rd
San Jose CA 95129-5031
Phone: (408) 255-0576
Fax: (408) 255-0577
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 6863T | California |
Profile Details
| NPI number | 1548230071 |
|---|---|
| LBN Legal business name | Ballentine, Kenneth H |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2006 |
| Last updated | Feb 3rd, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548230071 | NPPES |
| California | Other | 94-2710370 | FEDERAL TAXPAYER ID |
| California | MEDICAID | SD0068630 | FEDERAL TAXPAYER ID |
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