Kennedy, Charles Derensbough

Kennedy, Charles Derensbough is an sole proprietor health care provider with primary practice located at 229 Sycamore Grove St , Simi Valley CA 93065-7342. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Kennedy, Charles Derensbough can be contacted via phone (805) 217-6724.

Contact Information

Primary practice address
229 Sycamore Grove St Simi Valley CA 93065-7342
Phone: (805) 217-6724
Fax: (805) 217-6724
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G066894 California

Profile Details

NPI number 1942576111
LBN Legal business name Kennedy, Charles Derensbough
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 31st, 2012
Last updated Mar 31st, 2012 - about 14 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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