Individual
KEVIN J PRENDIVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 COBALT DR, DANA POINT, CA 92629-5906
(949) 388-9718
(949) 388-9215
Mailing address
11 COBALT DR, DANA POINT, CA 92629-5906
(949) 388-9718
(949) 388-9215
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G45074
CA
Other
Enumeration date
02/02/2006
Last updated
04/30/2010
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