Organization
KEN WILKENS MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH JAMES WILKENS M.D. (PRESIDENT)
(949) 364-2154
Entity
Organization
Contact information
Practice address
26730 CROWN VALLEY PKWY, SUITE 200, MISSION VIEJO, CA 92691-6364
(949) 364-2154
(949) 364-2110
Mailing address
26730 CROWN VALLEY PKWY, SUITE 200, MISSION VIEJO, CA 92691-6364
(949) 364-2154
(949) 364-2110
Taxonomy
Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
Primary
A80116
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679519649
NPI TYPE 1 (PERSONAL)
—
01
—
I28424
UPIN
CA
Enumeration date
04/19/2007
Last updated
07/26/2007
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