Individual
DR. KENNETH P TWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1106 PACIFIC ST, SAN LUIS OBISPO, CA 93401-3302
(805) 546-9500
(805) 546-9699
Mailing address
1106 PACIFIC ST, SAN LUIS OBISPO, CA 93401-3302
(805) 546-9500
(805) 546-9699
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G39105
CA
207RI0011X
Interventional Cardiology Physician
G39105
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G391050
—
CA
Enumeration date
10/29/2007
Last updated
10/29/2007
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