Individual
DR. MICHAEL KENNEDY TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6183 PASEO DEL NORTE STE 290, CARLSBAD, CA 92011-1151
(760) 603-9910
Mailing address
6183 PASEO DEL NORTE STE 290, CARLSBAD, CA 92011-1151
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C54009
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124229380
—
MI
05
—
9310791
—
OH
05
—
9310793
—
OH
05
—
9310794
—
OH
Enumeration date
05/29/2007
Last updated
09/25/2018
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