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Individual

DR. KENT W SMALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
411 N CENTRAL AVE STE 115, GLENDALE, CA 91203-3138
(818) 552-5040
(818) 552-5044
Mailing address
501 NORTH ORANGE STREET, SUITE 250, GLENDALE, CA 91203-1971
(818) 552-5040
(818) 552-5044

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A53173
CA
207WX0107X
Retina Specialist (Ophthalmology) Physician
A53173
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZZZ75843Z
CA
Enumeration date
01/03/2006
Last updated
04/12/2023
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