Individual provider · NPI-1

Kent Eunbae Ahn, MD

Family Medicine, Geriatric Medicine · Fontana, CA

NPI number1083762017
StatusActive
Last updated in NPPESDec 2, 2021

Details

NPI
1083762017
Entity type
Individual (NPI-1)
Name
Kent Eunbae Ahn
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jan 8, 2007
Last updated
Dec 2, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207QG0300X Family Medicine, Geriatric MedicineA96797CAYes

Practice location

9961 Sierra Ave
Fontana, CA 92335-6720

Phone 909-427-3910

Mailing address

9961 Sierra Ave
Fontana, CA 92335-6720

Phone 909-427-3910

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