Provider Demographics
NPI:1770605495
Name:KIENER, DAVID J (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:KIENER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1111 EXPOSITION BLVD BLDG 700
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4314
Mailing Address - Country:US
Mailing Address - Phone:916-736-3399
Mailing Address - Fax:916-233-4171
Practice Address - Street 1:5 MEDICAL PLAZA DR STE 100
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2866
Practice Address - Country:US
Practice Address - Phone:916-773-0395
Practice Address - Fax:916-736-6638
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2023-04-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG29773207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0400011479OtherRR MEDICARE PIN
CAAV049ZMedicare PIN
CAA44154Medicare UPIN