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Individual

KENNETH RICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1401 N TUSTIN AVE, STE 130, SANTA ANA, CA 92705-8644
(714) 542-3008
(714) 542-3617
Mailing address
506 16TH ST, HUNTINGTON BEACH, CA 92648-4014
(714) 374-9111
(714) 374-7311

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A50272
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A502720
CA
01
930128601
RAILROAD MEDICARE
CA
Enumeration date
07/20/2006
Last updated
05/19/2016
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