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General NPI Number Information
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NPI Number | 1861606402
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Entity Type | Individual
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Provider Name | JON H. KENDALL OD
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Gender | Male
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | 1125 E 17TH ST N-455
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City | SANTA ANA
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State | CA
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Zip | 92701-2201
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Country | US
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Telephone | 714-835-0141
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 E 17TH ST N-455
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City | SANTA ANA
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State | CA
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Zip | 92701-2201
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Country | US
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Telephone | 714-835-0141
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6974T
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License Number State | CA
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