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NPI Code Detail

MEDICARE: DR. CAROLINE ISIK KENNEDY M.D.

MEDICARE: DR. CAROLINE ISIK KENNEDY M.D.
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
1207Q00000XFamily Medicine PhysicianA70789CA

General Provider Information

NPI Number : 1033122478
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROLINE ISIK KENNEDY M.D.
Provider Business Mailing Address
First Line : 1615 BUNKER HILL WAY
Second Line : SUITE 100
City : SALINAS
State : CA
Zip : 93906-6013
Country : US
Telephone Number : 831-796-1304
Fax Number : 831-757-0291
Provider Business Practice Location Address
First Line : 1150 FREMONT BLVD
Second Line :
City : SEASIDE
State : CA
Zip : 93955-5715
Country : US
Telephone Number : 831-899-8100
Fax Number : 831-899-8105
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2006
Last Update Date : 11/17/2011

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