Provider Demographics
NPI:1326111964
Name:KENESSEY, BELA STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:BELA
Middle Name:STEVEN
Last Name:KENESSEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1320 EL CAPITAN DR
Mailing Address - Street 2:STE 400
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-6215
Mailing Address - Country:US
Mailing Address - Phone:925-277-1600
Mailing Address - Fax:925-277-1601
Practice Address - Street 1:1320 EL CAPITAN DR
Practice Address - Street 2:STE 400
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-6215
Practice Address - Country:US
Practice Address - Phone:925-277-1600
Practice Address - Fax:925-277-1601
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG069251207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF34549Medicare UPIN
CA00G692510Medicare ID - Type Unspecified