Provider Demographics
NPI:1477819456
Name:ATTENHOFER, KEVIN S (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:S
Last Name:ATTENHOFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:SPENCER
Other - Last Name:ATTENHOFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1180 N INDIAN CANYON DR STE W214
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4857
Mailing Address - Country:US
Mailing Address - Phone:760-416-4545
Mailing Address - Fax:
Practice Address - Street 1:1180 N INDIAN CANYON DR STE W214
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4857
Practice Address - Country:US
Practice Address - Phone:760-416-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1475832084N0400X
CA11610952084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA147583OtherSTATE MEDICAL LICENSE