Individual
DR. KEVIN RAY CHESEBRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9675 SWAN LAKE DR, GRANITE BAY, CA 95746-6608
(916) 797-1963
(916) 797-1963
Mailing address
9675 SWAN LAKE DR, GRANITE BAY, CA 95746-6608
(916) 797-1963
(916) 797-1963
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G85433
CA
Other
Enumeration date
10/22/2007
Last updated
10/22/2007
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