Individual
DR. MICHAEL GRANT KENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3307 RENNER DR, FORTUNA, CA 95540-3119
(707) 725-9832
(707) 725-7247
Mailing address
200 W CENTER STREET PROMENADE STE 400, ANAHEIM, CA 92805-3960
(714) 449-4841
(714) 449-4956
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301095163
MI
208600000X
Surgery Physician
Primary
A151367
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036139694
LICENSE
IL
Enumeration date
07/07/2009
Last updated
02/17/2021
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