Individual
KENNETH S KOENIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8935 OLNEY PARK DR, REDDING, CA 96001-9717
(530) 246-1139
(530) 246-9958
Mailing address
PO BOX 491836, REDDING, CA 96049-1836
(530) 246-1139
(530) 246-9958
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G63182
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G631820
—
CA
Enumeration date
04/18/2007
Last updated
08/11/2020
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