Basic Information
| Provider Information | |||||||||
| NPI: | 1154312585 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEMMLE | ||||||||
| FirstName: | KENNETH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3581 PALMER DR | ||||||||
| Address2: | SUITE 602 | ||||||||
| City: | CAMERON PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956828236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5306262920 | ||||||||
| FaxNumber: | 5306727048 | ||||||||
| Practice Location | |||||||||
| Address1: | 3581 PALMER DR | ||||||||
| Address2: | SUITE 602 | ||||||||
| City: | CAMERON PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956828236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5306262920 | ||||||||
| FaxNumber: | 5306727048 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2005 | ||||||||
| LastUpdateDate: | 08/25/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | G21257 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.