Bantol, Ken Iven
Bantol, Ken Iven is an sole proprietor health care provider with primary practice located at 10400 Gloria Ave , Granada Hills CA 91344-7123. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Bantol, Ken Iven can be contacted via phone (818) 867-0500.Contact Information
Primary practice address
10400 Gloria Ave
Granada Hills CA 91344-7123
Phone: (818) 867-0500
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 95027351 | California |
Profile Details
NPI number | 1841055811 |
---|---|
LBN Legal business name | Bantol, Ken Iven |
Credentials | PMHNP-BC |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Feb 19th, 2024 |
Last updated | Feb 19th, 2024 - about last year |
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 | 1841055811 | NPPES |
California | Other | 95027351 | NURSE PRACTITIONER FURNISHING |
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