Provider Demographics
NPI:1760404073
Name:SPAULDING, KENNETH FRANCIS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:FRANCIS
Last Name:SPAULDING
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:29525 CANWOOD ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4233
Mailing Address - Country:US
Mailing Address - Phone:818-706-1966
Mailing Address - Fax:818-706-9857
Practice Address - Street 1:29525 CANWOOD ST
Practice Address - Street 2:SUITE 214
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4233
Practice Address - Country:US
Practice Address - Phone:818-706-1966
Practice Address - Fax:818-706-9857
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG257002080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine