Provider Demographics
NPI:1366536898
Name:KENDER, PAUL E (PT)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:E
Last Name:KENDER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1001 S SEASIDE AVE
Mailing Address - Street 2:BLDG #23
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-7333
Mailing Address - Country:US
Mailing Address - Phone:310-521-6050
Mailing Address - Fax:310-521-6079
Practice Address - Street 1:1001 S SEASIDE AVE
Practice Address - Street 2:BLDG #23
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-7333
Practice Address - Country:US
Practice Address - Phone:310-521-6050
Practice Address - Fax:310-521-6079
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT7604225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist