Individual
EDWARD KIP HENSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
411 W 20TH ST, MERCED, CA 95340-3713
(209) 722-8122
(209) 722-9849
Mailing address
411 W 20TH ST, MERCED, CA 95340-3713
(209) 722-8122
(209) 722-9849
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
G43201
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G432010
—
CA
Enumeration date
12/05/2005
Last updated
01/12/2010
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