Individual
WESLEY E KINZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1401 SPANOS CT #101, MODESTO, CA 95355-2811
(209) 525-3140
(209) 525-3894
Mailing address
1401 SPANOS CT #101, MODESTO, CA 95355-2811
(209) 525-3140
(209) 525-3894
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G048580
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G485800
—
CA
Enumeration date
09/02/2006
Last updated
07/08/2007
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