Miselis, Kenneth Victor
Miselis, Kenneth Victor is an sole proprietor health care provider with primary practice located at 445 W Poplar St , Stockton CA 95203-2426. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Miselis, Kenneth Victor can be contacted via phone (209) 465-5933.Contact Information
Primary practice address
445 W Poplar St
Stockton CA 95203-2426
Phone: (209) 465-5933
Fax: (209) 465-2562
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 00G502810 | California |
Profile Details
| NPI number | 1730154592 |
|---|---|
| LBN Legal business name | Miselis, Kenneth Victor |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 22nd, 2006 |
| Last updated | Mar 23rd, 2009 - 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 | 1730154592 | NPPES |
| California | Other | 180033368 | RAILROAD MEDICARE |
| California | Other | 0761830001 | RAILROAD MEDICARE |
| California | MEDICAID | GR0050600 | RAILROAD MEDICARE |
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