Organization
SPINEINTERVENTION MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM E VON KAENEL MD (PHYSICIAN / OWNER)
(559) 435-0177
Entity
Organization
Contact information
Practice address
6121 N THESTA ST, STE 106, FRESNO, CA 93710-8603
(559) 435-1846
(559) 435-0127
Mailing address
6121 N THESTA ST, STE 106, FRESNO, CA 93710-8603
(559) 435-1846
(559) 435-0127
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
G691640
CA
Other
Enumeration date
09/08/2008
Last updated
09/08/2008
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