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General NPI Number Information
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NPI Number | 1013136696
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Entity Type | Organization
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Legal Business Name | KENT L COMBS M D INC
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 05/26/2010
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Provider Practice Location Address
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Address Line | 31862 COAST HWY SUITE 200
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-6769
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Country | US
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Telephone | 949-499-2253
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Fax | 949-499-9503
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Provider Business Mailing Address
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Address Line | 31862 COAST HWY SUITE 200
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-6769
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Country | US
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Telephone | 949-499-2253
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Fax | 949-499-9503
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENT L COMBS
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Credential | M.D.
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Telephone | 949-499-2253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | C27776
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License Number State | CA
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