Individual
KENNETH M DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
4445 MAGNOLIA AVE, RIVERSIDE, CA 92501
(951) 788-3000
Mailing address
2100 POWELL ST, STE 920, EMERYVILLE, CA 94608-1803
(510) 350-2600
(510) 879-9100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
3838
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX70600
—
CA
05
—
772485
—
AZ
Enumeration date
05/09/2006
Last updated
02/28/2008
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