Individual
JOHN R. KINNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9300 VALLEY CHILDRENS PL, MADERA, CA 93638-8761
(559) 353-5068
(559) 353-5426
Mailing address
9300 VALLEY CHILDRENS PL, MADERA, CA 93638-8761
(559) 353-5068
(559) 353-5426
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A82715
CA
208M00000X
Hospitalist Physician
Primary
A82715
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306887831
—
CA
Enumeration date
06/08/2006
Last updated
04/27/2020
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