Waldron, Kevin Gerard

Waldron, Kevin Gerard is an individual health care provider with primary practice located at 160 E Artesia St Ste 220 , Pomona CA 91767-2921. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Waldron, Kevin Gerard can be contacted via phone (909) 865-1020.

Contact Information

Primary practice address
160 E Artesia St Ste 220 Pomona CA 91767-2921
Phone: (909) 865-1020
Fax: (909) 865-1202
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 036.113732 Illinois
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 01060759A Indiana
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X C147602 California

Profile Details

NPI number 1659314540
LBN Legal business name Waldron, Kevin Gerard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Sep 13th, 2018 - about 7 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 1659314540 NPPES
Indiana Other 129164100 INDIANA DEPT OF LABOR
Indiana Other P00298697 INDIANA DEPT OF LABOR
Indiana Other 0375788 INDIANA DEPT OF LABOR
Indiana MEDICAID 200800980 INDIANA DEPT OF LABOR

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