Individual
DR. KENNETH LESLIE BALDWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1304 ELLA ST, STE B-1, SAN LUIS OBISPO, CA 93401-4166
(805) 546-8662
(805) 546-8665
Mailing address
1304 ELLA ST, STE B-1, SAN LUIS OBISPO, CA 93401-4166
(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
—
77-0113784
TAXPAYER ID NUMBER
CA
01
—
G34268
MEDICAL LICENSE NUMBER
CA
Enumeration date
07/15/2006
Last updated
03/07/2023
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