Individual
DR. KENNETH TYE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1250 S SUNSET AVE, WEST COVINA, CA 91790-3962
(626) 960-6588
(626) 338-0688
Mailing address
1250 S SUNSET AVE, SUITE202, WEST COVINA, CA 91790-3961
(626) 960-6588
(626) 338-0688
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A32035
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A32035
STATE LICENSE NUMBER
AR
Enumeration date
08/03/2005
Last updated
07/09/2007
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