# KENNETH WELLS, DPM, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215111935
- **Authorized official:** DR. KENNETH WELLS D.P.M. (PODIATRIST/PRESIDENT)
- **Authorized official phone:** (619) 527-0051

## Contact information

- **Practice address:** 286 EUCLID AVE, 204, SAN DIEGO, CA 92114-3610
- **Practice address phone:** (619) 527-0051
- **Practice address fax:** (619) 527-0056
- **Mailing address:** 286 EUCLID AVE, 204, SAN DIEGO, CA 92114-3610
- **Mailing address phone:** (619) 527-0051
- **Mailing address fax:** (619) 527-0056

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 4728380001 | CA | Yes |

## Other

- **Enumeration date:** 12/18/2007
- **Last updated:** 12/18/2007