Small, Kent W
Small, Kent W is an sole proprietor health care provider with primary practice located at 411 N Central Ave Ste 115 , Glendale CA 91203-3138. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Retina Specialist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Small, Kent W can be contacted via phone (818) 552-5040.Contact Information
Primary practice address
411 N Central Ave Ste 115
Glendale CA 91203-3138
Phone: (818) 552-5040
Fax: (818) 552-5044
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Retina Specialist | 207WX0107X | A53173 | California |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | A53173 | California |
Profile Details
| NPI number | 1861470783 |
|---|---|
| LBN Legal business name | Small, Kent W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 3rd, 2006 |
| Last updated | Apr 12th, 2023 - about last year |
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 | 1861470783 | NPPES |
| California | MEDICAID | ZZZ75843Z |
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