Organization
KENLEY EMERGENCY MEDICINE CORPORATION
Active
Other names
MEDICUS VIP
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC S KENLEY MD (OWNER)
(773) 632-7244
Entity
Organization
Contact information
Practice address
100 N WIGET LN STE 200, WALNUT CREEK, CA 94598-5901
(773) 632-7244
Mailing address
100 N WIGET LN STE 200, WALNUT CREEK, CA 94598-5901
(773) 632-7244
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
A100640
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194847475
—
CA
Enumeration date
08/18/2017
Last updated
07/21/2022
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