Individual
KEN J HINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1555 SOQUEL DR, SANTA CRUZ, CA 95065-1794
(831) 462-7700
Mailing address
11455 ASTER ST APT 1/2, LOMA LINDA, CA 92354-3401
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A180141
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2019
Last updated
04/09/2025
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