De Los Reyes, Kenneth Marcel

De Los Reyes, Kenneth Marcel is an sole proprietor health care provider with primary practice located at 11234 Anderson St , Loma Linda CA 92350-1716. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. De Los Reyes, Kenneth Marcel can be contacted via phone (909) 558-4419.

Contact Information

Primary practice address
11234 Anderson St Loma Linda CA 92350-1716
Fax: (909) 558-4825
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X C131686 California

Profile Details

NPI number 1134388879
LBN Legal business name De Los Reyes, Kenneth Marcel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 6th, 2008
Last updated Feb 28th, 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 1134388879 NPPES
California MEDICAID 1134388879

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