Individual
MR. KENNETH MICHAEL BECERRIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACA
Contact information
Practice address
5908 MAGNOLIA AVE, RIVERSIDE, CA 92506-1884
(951) 779-1237
(951) 779-1238
Mailing address
5908 MAGNOLIA AVE, RIVERSIDE, CA 92506-1884
(951) 779-1237
(951) 779-1238
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA3537
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
611A63223
BLUE CROSS OF CALIF.
CA
01
—
BEL-45460
SECUREHORIZONS-PACIFICARE
CA
01
—
ZZZ64762Z
BLUE CARD
CA
Enumeration date
12/07/2006
Last updated
07/08/2007
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