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Dr. Kenneth Victor Miselis, MD
Specialist in Stockton, California
NPI 1730154592

Kenneth Victor Miselis is a Specialist based in Stockton, CA. Kenneth Victor Miselis practices in Stockton, CA and has the professional credentials of MD. The NPI Number for Kenneth Victor Miselis is 1730154592 and holds a License No. 00G502810 (California).

The current practice location address for Kenneth Victor Miselis is 445 W Poplar St, Stockton, CA and can be reached out via phone at 209-465-5933 and via fax at 209-465-2562. You can also correspond with Kenneth Victor Miselis through the mailing address at 445 W POPLAR ST, STOCKTON, CA - 95203-2426 (mailing address contact number: 209-465-5933).

Location: 445 W Poplar St, Stockton, CA, 95203-2426
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730154592
Provider Name
Kenneth Victor Miselis
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
445 W Poplar St, Stockton, CA, 95203-2426
Phone Number
209-465-5933
Fax Number
209-465-2562
Provider Enumeration Date
02/22/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
180033368 01 CA RAILROAD MEDICARE
0761830001 01 CA MEDICARE DMERC
GR0050600 05 CA
institution
Provider Business Practice Location Address Details
Address
445 W Poplar St
City
Stockton
State
California
Zip
95203-2426
Phone Number
209-465-5933
Fax Number
209-465-2562
person
Provider Business Mailing Address Details
Address
445 W Poplar St
City
Stockton
State
California
Zip
95203-2426
Phone Number
209-465-5933
Fax Number
209-465-2562
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
00G502810 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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