Individual
DR. KENNETH A KELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
734 MOWRY AVE, FREMONT, CA 94536
(510) 793-3033
(510) 793-4952
Mailing address
734 MOWRY AVE, FREMONT, CA 94536-4115
(510) 793-3033
(510) 793-4952
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G250930
CA
207RG0100X
Gastroenterology Physician
Primary
G250930
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1455018
—
CA
Enumeration date
03/13/2007
Last updated
06/01/2018
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