Tracy, Michael Kennedy
Tracy, Michael Kennedy is an individual health care provider with primary practice located at 6183 Paseo Del Norte Ste 290 , Carlsbad CA 92011-1151. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Tracy, Michael Kennedy can be contacted via phone (760) 603-9910.Contact Information
Primary practice address
6183 Paseo Del Norte Ste 290
Carlsbad CA 92011-1151
Phone: (760) 603-9910
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | C54009 | California |
Profile Details
| NPI number | 1124229380 |
|---|---|
| LBN Legal business name | Tracy, Michael Kennedy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 29th, 2007 |
| Last updated | Sep 25th, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124229380 | NPPES |
| Michigan | MEDICAID | 1124229380 | |
| Michigan | MEDICAID | 9310794 | |
| Michigan | MEDICAID | 9310791 | |
| Michigan | MEDICAID | 9310793 |
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