Individual
DR. CASEY M. KENNEDY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2 W FERN AVE, REDLANDS, CA 92373-5916
(909) 793-3311
(909) 796-4158
Mailing address
PO BOX 10069, SAN BERNARDINO, CA 92423-0069
(909) 335-4188
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G733790
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G733790
—
CA
Enumeration date
06/14/2006
Last updated
06/27/2017
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