Provider Demographics
NPI:1689626566
Name:THOMAS, KENNETH HUNT (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:HUNT
Last Name:THOMAS
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 1:710 S. BROOKHURST ST. # 3
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804
Mailing Address - Country:US
Mailing Address - Phone:714-270-3917
Mailing Address - Fax:714-844-4725
Practice Address - Street 1:7311 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-1999
Practice Address - Country:US
Practice Address - Phone:818-281-2954
Practice Address - Fax:818-782-7454
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44107207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine