Individual
DR. KENNETH ECONOMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6880 PALM AVE, SEBASTOPOL, CA 95472-4270
(707) 823-7628
(707) 823-1521
Mailing address
210 N TUSTIN AVE, SANTA ANA, CA 92705-3807
(714) 347-1010
(714) 647-1245
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G32010
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G320100
—
CA
01
—
P01731276
RR PTAN
CA
Enumeration date
07/31/2006
Last updated
11/28/2016
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