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NPI Code Detail

MEDICARE: KENNETH NEAL BLEU I

MEDICARE:   KENNETH NEAL BLEU I
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747A0650XAttendant Care Provider

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1B3258207OTHERCALICENSE

General Provider Information

NPI Number : 1982550224
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH NEAL BLEU I
Provider Business Mailing Address
First Line : 2155 FELSPAR ST APT 9
Second Line :
City : SAN DIEGO
State : CA
Zip : 92109-3626
Country : US
Telephone Number : 619-782-2014
Fax Number :
Provider Business Practice Location Address
First Line : 2605 E 2ND ST
Second Line :
City : NATIONAL CITY
State : CA
Zip : 91950-2013
Country : US
Telephone Number : 619-791-9864
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2026
Last Update Date : 03/09/2026

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Directions to “ KENNETH NEAL BLEU I ” Practice Location

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