Dale, Kenneth M

Dale, Kenneth M is an individual health care provider with primary practice located at 4445 Magnolia Ave , Riverside CA 92501. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Dale, Kenneth M can be contacted via phone (951) 788-3000.

Contact Information

Primary practice address
4445 Magnolia Ave Riverside CA 92501
Phone: (951) 788-3000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 3838 Arizona

Profile Details

NPI number 1932158771
LBN Legal business name Dale, Kenneth M
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2006
Last updated Feb 28th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932158771 NPPES
Arizona MEDICAID 772485
Arizona MEDICAID 00AX70600

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