Organization
KENNETH L BALDWIN M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA MARIE GARCIA (ADMINISTRATION)
(805) 546-8662
Entity
Organization
Contact information
Practice address
1304 ELLA ST, SUITE B-1, SAN LUIS OBISPO, CA 93401-4100
(805) 546-8662
(805) 546-8665
Mailing address
1304 ELLA ST, SUITE B, SAN LUIS OBISPO, CA 93401-4100
(805) 546-8662
(805) 546-8665
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G34268
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FF235A
PTAN
CA
Enumeration date
09/27/2016
Last updated
09/27/2016
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