KENNETH STEVENS MD INC A MEDICAL CORPORATION NPI 1265606081

NPI Information

NPI: 1265606081
Provider Name: KENNETH STEVENS MD INC A MEDICAL CORPORATION

Doing Business As: PREMIER HEART CARE INC

Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
3231 S HIGUERA ST
SAN LUIS OBISPO, CA
ZIP 93401
Phone: (805) 540-3333
Get Directions

KENNETH STEVENS MD INC A MEDICAL CORPORATION is a cardiovascular disease internal medicine in San Luis Obispo, CA. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. KENNETH STEVENS MD INC A MEDICAL CORPORATION NPI is 1265606081. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Premier Heart Care Inc.

The provider's business location address is:

3231 S HIGUERA ST
SAN LUIS OBISPO, CA
ZIP 93401-924
Phone: (805) 540-3333
Fax: (805) 540-3344

The provider's authorized official is Kenneth Stevens .
The authorized official title is President and has the following contact phone number (805) 540-3333.

The enumeration date for this NPI number is 4/14/2008 and was last updated on 10/6/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	AV517	MEDICARE PIN	CALIFORNIA
2	DIGIRAD CARDIUS 2XPO	OTHER	CALIFORNIA	AMER COLLEGE OF RADIOLOGY- NUCLEAR MEDICINE ACCREDITATION
3	37534	OTHER	CALIFORNIA	MEDICAL BOARD FICTITIOUS NAME PERMIT NUMBER
4	C3092297	OTHER	CALIFORNIA	DEPT OF CORPORATIONS NUMBER
5	05D1083425	OTHER	CALIFORNIA	CLIA CERTIFICATE OF WAIVER NUMBER
6	106286	OTHER	CALIFORNIA	CITY OF SAN LUIS OBISPO BUSINESS LICENSE
7	ZZZ53712Y	OTHER	CALIFORNIA	BLUE SHIELD PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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