Kenneth H. Ballentine Od Inc.
LBN: Kenneth H. Ballentine Od Inc.
Kenneth H. Ballentine Od Inc. is an health care organization with primary practice located at 5275 Prospect Rd , San Jose CA 95129-5031. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Suppliers / Eyewear Supplier (Equipment, not the service). Suppliers / Eyewear Supplier (Equipment, not the service) is the primary health care specialty.
Kenneth H. Ballentine Od Inc. can be contacted via phone (408) 255-0576, or through Ballentine, Kenneth H via phone (408) 255-0576.
Contact Information
Primary practice address
5275 Prospect Rd
San Jose CA 95129-5031
Phone: (408) 255-0576
Fax:
Website:
Authorized official contact:
Name: Ballentine, Kenneth H Doctor of Optometry (OD)
Phone: (408) 255-0576
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 6863T | California |
| Suppliers / Eyewear Supplier (Equipment, not the service) | 332H00000X | 6863T | California |
Profile Details
| NPI number | 1649448507 |
|---|---|
| LBN Legal business name | Kenneth H. Ballentine Od Inc. |
| DBA Doing business as | |
| Authorized official | Ballentine, Kenneth H Doctor of Optometry (OD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 13th, 2008 |
| Last updated | Sep 6th, 2012 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649448507 | NPPES |
| California | MEDICAID | SD0068630 |
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