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Individual

DR. KENNETH POMAR REBONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2350 MCKEE RD, SUITE 1, SAN JOSE, CA 95116-1617
(408) 729-3232
(408) 729-2165
Mailing address
2350 MCKEE RD, SUITE 1, SAN JOSE, CA 95116-1617
(408) 729-3232
(408) 729-2165

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
A45813
CA
208D00000X
General Practice Physician
Primary
A045813
CA

Other

Enumeration date
07/31/2006
Last updated
04/06/2016
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