Provider Demographics
NPI:1285680959
Name:BRANSFORD, KENT (MD)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:
Last Name:BRANSFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HARRIS CT BLDG T
Mailing Address - Street 2:2ND FLOOR # 201
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5750
Mailing Address - Country:US
Mailing Address - Phone:831-375-4105
Mailing Address - Fax:831-372-5722
Practice Address - Street 1:5 HARRIS CT BLDG T
Practice Address - Street 2:2ND FLOOR # 201
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5750
Practice Address - Country:US
Practice Address - Phone:831-375-4105
Practice Address - Fax:831-372-5722
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG45162207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G451620Medicaid
00G451620OtherBCBS
GR0080140OtherMEDICAID GRUOP #
ZZZ13460ZOtherMEDICARE GROUP#
CA00G451620Medicaid
GR0080140OtherMEDICAID GRUOP #