Individual
MR. KENNETH R GILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
277 COHASSET RD, CHICO, CA 95926-2242
(530) 872-6650
Mailing address
5900 N LIBBY RD, PARADISE, CA 95969-4215
(530) 872-5191
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA15850
CA
Other
Enumeration date
03/23/2006
Last updated
01/02/2019
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