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Contact Information

KENNETH VERESCHAGIN, MD
2652 EL CAMINO REAL
SANTA CLARA, CA95051-3041
 Phone: 408-524-5952
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2080S0010X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for KENNETH VERESCHAGIN · (Male)

NPI # 1497837785
Status Active
Credentials MD
Entity Individual
Enumeration date 10/19/2006
Last updated 12/02/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • CA License # G61515
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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