KENNETH B LAKE

FONTANA, CA
NPI1003964024
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: CA  NA3286)
Enumeration Date2007-01-08
Last Update Date2008-09-15
Business Address
KENNETH B LAKE CRNA
9961 SIERRA AVE
FONTANA, CA 92335-6720
Phone number: 909-427-3910
Mailing Address
KENNETH B LAKE CRNA
9961 SIERRA AVE
FONTANA, CA 92335-6720
Phone number: 909-427-3910
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