Individual
MR. KEVIN MCCARTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 GRAND AVE, SAN LUIS OBISPO, CA 93407-0210
(805) 756-1211
Mailing address
1 GRAND AVE, SAN LUIS OBISPO, CA 93407-0210
(805) 756-1211
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
PA10993
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA10993
STATE LICENSE
CA
Enumeration date
08/05/2009
Last updated
03/07/2023
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