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Individual

KEVIN CULLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3206 W BALBOA BLVD, NEWPORT BEACH, CA 92663-3018
(949) 723-2388
(949) 723-1288
Mailing address
3419 VIA LIDO, NEWPORT BEACH, CA 92663-3908
(949) 723-2388
(949) 723-1288

Taxonomy

Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
0041750
CA

Other

Enumeration date
08/08/2012
Last updated
08/08/2012
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