Lyons, Kenneth P.

Lyons, Kenneth P. is an sole proprietor health care provider with primary practice located at 20162 Sw Birch St Suite 150, Newport Beach CA 92660-0787. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nuclear Medicine, which is considered as his primary health care specialty. Lyons, Kenneth P. can be contacted via phone (949) 221-1700.

Contact Information

Primary practice address
20162 Sw Birch St Suite 150 Newport Beach CA 92660-0787
Phone: (949) 221-1700
Fax: (949) 221-1704
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nuclear Medicine 207U00000X G12843 California

Profile Details

NPI number 1770523391
LBN Legal business name Lyons, Kenneth P.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 8th, 2006
Last updated Jul 8th, 2007 - about 18 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 1770523391 NPPES
California Other 00G128430 BLUE SHIELD
California MEDICAID 00G128430 BLUE SHIELD

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