Individual
MICHAEL SCOTT KENLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
511 BATH ST, SANTA BARBARA, CA 93101-3403
(805) 963-9377
(805) 962-2154
Mailing address
511 BATH ST, SANTA BARBARA, CA 93101-3403
(805) 963-9377
(805) 962-2154
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
62730
GA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A113590
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A113590
DCA MEDICAL LICENSE
CA
01
—
EJ158Y
NORTHERN MEDICARE PTAN
CA
01
—
EJ158Z
SOUTHERN MEDICARE PTAN
CA
Enumeration date
12/29/2007
Last updated
08/19/2015
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