Beenken, Kandice Renee

Beenken, Kandice Renee is an individual health care provider with primary practice located at 3750 Convoy St Ste 201 , San Diego CA 92111-3770. She recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as her primary health care specialty. Beenken, Kandice Renee can be contacted via phone (858) 278-8031.

Contact Information

Primary practice address
3750 Convoy St Ste 201 San Diego CA 92111-3770
Phone: (858) 278-8031
Fax: (858) 278-1708
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 5101019407 Michigan
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X DO2030 Nevada
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 20A15340 California

Profile Details

NPI number 1982991501
LBN Legal business name Beenken, Kandice Renee
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2011
Last updated Jul 21st, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982991501 NPPES
California Other 20A15340 CA MEDICAL LICENSE
California Other 5101019407 CA MEDICAL LICENSE
California Other DO2030 CA MEDICAL LICENSE
California MEDICAID 1982991501 CA MEDICAL LICENSE

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