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General NPI Number Information
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NPI Number | 1861580599
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Entity Type | Individual
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Provider Name | MICHAEL GENE KINNISON M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1445 VETERANS MEMORIAL CIRCLE
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City | YUBA CITY
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State | CA
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Zip | 95993
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Country | US
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Telephone | 530-822-7215
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Fax |
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Provider Business Mailing Address
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Address Line | 750 LINCOLN RD APT 23
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City | YUBA CITY
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State | CA
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Zip | 95991-6600
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Country | US
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Telephone | 530-673-8067
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Fax | 530-822-7223
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G40769
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License Number State | CA
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