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1053745059
KENNETH NICHOLAS HALTER
LA JOLLA, CA
NPI
1053745059
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA22613)
Enumeration Date
2013-08-26
Last Update Date
2017-09-20
Business Address
Mr. KENNETH NICHOLAS HALTER PA-C
9350 CAMPUS POINT DR
LA JOLLA, CA 92037-1300
Phone number: 858-657-6035
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Mailing Address
Mr. KENNETH NICHOLAS HALTER PA-C
PO BOX 232410
SAN DIEGO, CA 92193-2410
Phone number:
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