| Kenan & Wang Llc | |
|
331 J St Sacramento CA 95814-2211 | |
| (916) 553-0028 | |
| (916) 553-0038 |
| Full Name | Kenan & Wang Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 331 J St, Sacramento, California |
| Authorized Official Name and Position | Kenan Si (OWNER) |
| Authorized Official Contact | 9165805249 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenan & Wang Llc 9522 Bullion Way Orangevale CA 95662-5427 Ph: (916) 580-5249 | Kenan & Wang Llc 331 J St Sacramento CA 95814-2211 Ph: (916) 553-0028 |
| NPI Number | 1346485075 |
|---|---|
| Provider Enumeration Date | 12/09/2008 |
| Last Update Date | 12/09/2008 |
| Medicare PECOS PAC ID | 7618038357 |
|---|---|
| Medicare Enrollment ID | O20081212000429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346485075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A99168 (California) | Primary |
| Provider Name | Kenan Si |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124144266 PECOS PAC ID: 6002900792 Enrollment ID: I20070926000447 |
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