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Individual
DR. KENNETH ROBERT STIVER
Active
Individual
DR. KENNETH ROBERT STIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G28027
CA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
MD60996184
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G280270
—
CA
Enumeration date
08/01/2007
Last updated
02/05/2026
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