Provider Demographics
NPI:1497020085
Name:DOBSON, KENNETH G (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:G
Last Name:DOBSON
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16817 HALLMARK CT
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-1632
Mailing Address - Country:US
Mailing Address - Phone:510-353-8535
Mailing Address - Fax:
Practice Address - Street 1:16817 HALLMARK CT
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94552-1632
Practice Address - Country:US
Practice Address - Phone:510-353-8535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA307522083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine