Eller, Kent C

Eller, Kent C is an individual health care provider with primary practice located at 1080 Marina Village Pkwy Ste 100 , Alameda CA 94501-1078. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Eller, Kent C can be contacted via phone (103) 377-9505.

Contact Information

Primary practice address
1080 Marina Village Pkwy Ste 100 Alameda CA 94501-1078
Phone: (103) 377-9505
Fax: (602) 685-3808
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 33041 Arizona
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X C142177 California

Profile Details

NPI number 1235186313
LBN Legal business name Eller, Kent C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2006
Last updated Oct 8th, 2019 - about 6 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 1235186313 NPPES
Arizona MEDICAID 875437

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