Jutzy, Kenneth
Jutzy, Kenneth is an individual health care provider with primary practice located at 11234 Anderson St #1617, Loma Linda CA 92354-2804. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Jutzy, Kenneth can be contacted via phone (909) 558-8591.Contact Information
Primary practice address
11234 Anderson St #1617
Loma Linda CA 92354-2804
Phone: (909) 558-8591
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | G37876 | California |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | G37876 | California |
Profile Details
| NPI number | 1073531802 |
|---|---|
| LBN Legal business name | Jutzy, Kenneth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Apr 12th, 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 | 1073531802 | NPPES |
| California | MEDICAID | 00G378760 |
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