Individual
DR. KENNETH FAUBEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
UNITED STATES COAST GUARD MEDICAL CLINIC, 1001 S. SEASIDE AVE., BLDG 23, SAN PEDRO, CA 90731
(310) 521-6060
Mailing address
UNITED STATES COAST GUARD MEDICAL CLINIC, 1001 S. SEASIDE AVE., BLDG 23, SAN PEDRO, CA 90731
(310) 521-6060
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
207Q00000X
Family Medicine Physician
0102203951
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/05/2013
Last updated
05/21/2025
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