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Individual
KENNETH R. KENDALL
Active
Individual
KENNETH R. KENDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT9482T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1312330002
MEDICARE DMERC
—
01
—
P00190674
MEDICARE RAILROAD
CA
05
—
SD0094820
—
CA
Enumeration date
05/24/2005
Last updated
07/29/2015
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