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NPI Code Detail

MEDICARE: KIRK L JENSEN MD

MEDICARE: KIRK L JENSEN MD
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
1207X00000XOrthopaedic Surgery PhysicianG68904CA

General Provider Information

NPI Number : 1568553790
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRK L JENSEN MD
Provider Business Mailing Address
First Line : 3717 MT DIABLO BLVD STE 100
Second Line :
City : LAFAYETTE
State : CA
Zip : 94549-3547
Country : US
Telephone Number : 925-284-5300
Fax Number : 925-284-5381
Provider Business Practice Location Address
First Line : 3717 MT DIABLO BLVD STE 100
Second Line :
City : LAFAYETTE
State : CA
Zip : 94549-3547
Country : US
Telephone Number : 925-284-5300
Fax Number : 925-354-5381
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 02/11/2025

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