| Jack Kennis Md Inc | |
|
27080 Big Horn Mountain Way Yorba Linda CA 92887-4210 | |
| (714) 692-0800 | |
| Not Available |
| Full Name | Jack Kennis Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 27080 Big Horn Mountain Way, Yorba Linda, California |
| Authorized Official Name and Position | Jack Kennis (CEO) |
| Authorized Official Contact | 7146920800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack Kennis Md Inc 27080 Big Horn Mountain Way Yorba Linda CA 92887-4210 Ph: (714) 692-0800 | Jack Kennis Md Inc 27080 Big Horn Mountain Way Yorba Linda CA 92887-4210 Ph: (714) 692-0800 |
| NPI Number | 1033922497 |
|---|---|
| Provider Enumeration Date | 01/29/2025 |
| Last Update Date | 02/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033922497 | NPI | - | NPPES |
| 1477504249 | Other | CA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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