institution
Kenneth Stevens Md Inc A Medical Corporation
Cardiovascular Disease Physician in San Luis Obispo, California
NPI 1265606081

Kenneth Stevens Md Inc A Medical Corporation is a Cardiovascular Disease Physician based in San Luis Obispo, CA and is specialized in Cardiovascular Disease. Kenneth Stevens Md Inc A Medical Corporation practices in San Luis Obispo, CA. The NPI Number for Kenneth Stevens Md Inc A Medical Corporation is 1265606081 and holds a License No. (California).

The current practice location address for Kenneth Stevens Md Inc A Medical Corporation is 3231 S Higuera St, San Luis Obispo, CA and can be reached out via phone at 805-540-3333 and via fax at 805-540-3344.

Location: 3231 S Higuera St, San Luis Obispo, CA, 93401-6924
institution
Provider Profile Details
NPI Number
1265606081
Provider Name
Kenneth Stevens Md Inc A Medical Corporation
Credential
Provider Entity Type
Organization
Address
3231 S Higuera St, San Luis Obispo, CA, 93401-6924
Phone Number
805-540-3333
Fax Number
805-540-3344
Provider Enumeration Date
04/14/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
05D1083425 01 CA CLIA CERTIFICATE OF WAIVER NUMBER
C3092297 01 CA DEPT OF CORPORATIONS NUMBER
37534 01 CA MEDICAL BOARD FICTITIOUS NAME PERMIT NUMBER
DIGIRAD CARDIUS 2XPO 01 CA AMER COLLEGE OF RADIOLOGY- NUCLEAR MEDICINE ACCREDITATION
ZZZ53712Y 01 CA BLUE SHIELD PROVIDER NUMBER
106286 01 CA CITY OF SAN LUIS OBISPO BUSINESS LICENSE
institution
Provider Business Practice Location Address Details
Address
3231 S Higuera St
City
State
Zip
93401-6924
Phone Number
805-540-3333
Fax Number
805-540-3344
person
Provider Business Mailing Address Details
Address
3231 S Higuera St
City
State
Zip
93401-6924
Phone Number
805-540-3333
Fax Number
805-540-3344
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Cardiovascular Disease
Taxonomy
License No.
()
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
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