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Organization
PENN, KANAYA, DWELLE, MD'S
Active
Organization
PENN, KANAYA, DWELLE, MD'S
Active
Parent organization
PENN, KANAYA, DWELLE, MD'S
Other names
Pediatric Group of Monterey
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN, KANAYA, DWELLE, MD'S
Authorized official
KATHIE L STARK (EXECUTIVE DIRECTOR)
(831) 372-5841
Entity
Organization
Contact information
Practice address
1900 GARDEN RD STE 110, MONTEREY, CA 93940-5334
(831) 372-5841
(831) 372-4820
Mailing address
1900 GARDEN RD, SUITE 110, MONTEREY, CA 93940-5373
(831) 372-5841
(831) 372-4820
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053417212
—
CA
Enumeration date
09/15/2006
Last updated
06/25/2010
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