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Individual

KENNETH M CALDWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3717 MT DIABLO BLVD STE 100, LAFAYETTE, CA 94549-3547
(925) 284-5300
(925) 284-5381
Mailing address
PO BOX 1298, LAFAYETTE, CA 94549-1298
(925) 284-5300
(925) 284-5381

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A22558
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A225581
STATE LICENSE NUMBER
CA
05
00A225581
CA
Enumeration date
06/01/2006
Last updated
06/16/2018
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