Individual
KEAN S. GANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
655 LAGUNA DR, CARLSBAD, CA 92008-1610
(760) 729-7101
(760) 729-7106
Mailing address
225 S LAKE AVE, 535, PASADENA, CA 91101-3005
(626) 795-6596
(626) 795-8247
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20A3146
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020A31460
BLUE SHIELD
CA
05
—
020A31460
—
CA
Enumeration date
07/30/2006
Last updated
08/05/2010
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