Kennedy, Warren Leigh

Kennedy, Warren Leigh is an individual health care provider with primary practice located at 1401 Sylvan Ave , Modesto CA 95355-1367. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kennedy, Warren Leigh can be contacted via phone (209) 527-6640.

Contact Information

Primary practice address
1401 Sylvan Ave Modesto CA 95355-1367
Phone: (209) 527-6640
Fax: (209) 527-5489
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 6390TPA California

Profile Details

NPI number 1629069307
LBN Legal business name Kennedy, Warren Leigh
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Sep 6th, 2012 - about 12 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 1629069307 NPPES
California Other 12100 MEDICAL EYE SERVICES

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