Provider Demographics
NPI:1578585857
Name:KENT, DANA TRAVIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:TRAVIS
Last Name:KENT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:559 E ALISAL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-2516
Mailing Address - Country:US
Mailing Address - Phone:831-769-1304
Mailing Address - Fax:831-757-0291
Practice Address - Street 1:1150 FREMONT BLVD
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:CA
Practice Address - Zip Code:93955-5715
Practice Address - Country:US
Practice Address - Phone:831-899-8100
Practice Address - Fax:831-899-8105
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG75804207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF96467Medicare UPIN
CAZZZ15686ZMedicare ID - Type UnspecifiedCOUNTY OF MONTEREY GROUP