Individual
KENNETH JOHN BLUNT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5942 AVENIDA CHAMNEZ, LA JOLLA, CA 92037-7402
(858) 459-5977
(858) 459-5977
Mailing address
5942 AVENIDA CHAMNEZ, LAJOLLA, CA 92037-7402
(858) 459-5977
(858) 459-5977
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G21211
CA
Other
Enumeration date
05/18/2012
Last updated
05/18/2012
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