Individual
KENTY UY SIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1855 E ALLUVIAL AVE, STE. 101, FRESNO, CA 93720-3854
(559) 797-0501
(559) 797-0504
Mailing address
1855 E ALLUVIAL AVE, STE 101, FRESNO, CA 93720-3854
(559) 797-0501
(559) 797-0504
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A75906
CA
208600000X
Surgery Physician
A75906
CA
2086S0122X
Plastic and Reconstructive Surgery Physician
A75906
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OOA759060
—
CA
Enumeration date
06/24/2006
Last updated
05/04/2018
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