KENNETH UNTALAN
NPI 1750810206
Student in an Organized Health Care Education/Training Program in Fresno, CA

Active since June 08, 2017
1620 EAST BULLDOG LANE, FRESNO, CA 93710(559) 278-4170(559) 278-8355 Get Directions Write a Review

NPPES record last updated: June 8, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Kenneth Untalan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH UNTALAN (NPI 1750810206) is an individual student in an organized health care education/training program provider in Fresno, California and active in the NPI registry since June 2017.Information from the official NPPES registry record, last updated June 8, 2017.

NPPES Registry Identity

NPI1750810206
Entity TypeIndividualMale
Provider Legal NameKENNETH UNTALAN
Location Address1620 EAST BULLDOG LANEFresno, CA 93710
Mailing Address1906 12th AveDelano, CA 93215-3835 · (661) 703-9645
Fax(559) 278-8355
Sole ProprietorNo
Enumeration DateJune 8, 2017
NPI 1750810206 is a valid, active identifier and passes the ISO check-digit test. How NPI validation works

Primary Specialty

Student in an Organized Health Care Education/Training Program

Taxonomy 390200000X · Student, Health Care

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also Listed

Specialist/Technologist · Athletic Trainer

Taxonomy 2255A2300X · Respiratory, Developmental, Rehabilitative and Restorative Service Providers

1620 EAST BULLDOG LANE, Fresno, CA 93710

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1750810206, enumerated as an "individual" on June 08, 2017.

The provider is located at 1620 EAST BULLDOG LANE FRESNO, CA 93710 and the phone number is (559) 278-4170.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.