Woodburn, Kevin Dlyn

Woodburn, Kevin Dlyn is an individual health care provider with primary practice located at 400 Sierra College Dr. Suite A, Grass Valley CA 95945. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Woodburn, Kevin Dlyn can be contacted via phone (530) 272-3411.

Contact Information

Primary practice address
400 Sierra College Dr. Suite A Grass Valley CA 95945
Phone: (530) 272-3411
Fax: (530) 272-3474
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 6840TLG California

Profile Details

NPI number 1912953217
LBN Legal business name Woodburn, Kevin Dlyn
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Jan 10th, 2013 - about 12 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 1912953217 NPPES
California MEDICAID SD0068400

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