Provider Demographics
NPI:1811915986
Name:KENT, STEVEN (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:KENT
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 1:2416 CASTILLO ST STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-5303
Mailing Address - Country:US
Mailing Address - Phone:805-682-2655
Mailing Address - Fax:805-682-9762
Practice Address - Street 1:2416 CASTILLO ST STE A
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-5303
Practice Address - Country:US
Practice Address - Phone:805-682-2655
Practice Address - Fax:805-682-9762
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG59775174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE55360Medicare UPIN