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Individual

MR. WARREN LEIGH KENNEDY

Active
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Individual

MR. WARREN LEIGH KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6390TPA
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12100
MEDICAL EYE SERVICES
CA
Enumeration date
11/02/2005
Last updated
09/06/2012
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