Individual
KEVIN DINGLASAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2227 PIEDMONT AVE, 170 SIMPSON CENTER, BERKELEY, CA 94720-2325
(510) 642-4878
Mailing address
839 BRIDLE RIDGE DR, FAIRFIELD, CA 94534-6748
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/14/2014
Last updated
04/14/2014
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