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Kenneth Untalan
NPI 1750810206 · on the registry since 2017
Practice
- Address
- 1620 East Bulldog Lane
Fresno, CA 93710 - Phone
- (559) 278-4170
- Fax
- (559) 278-8355
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 390200000X
390200000X
- Also registered as
- 2255A2300X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2017-06-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California