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Kevin Christopher Osborn

Dentist

Dental Providers

2451 Jamacha Rd, Suite 104, El Cajon, CA 92019-4324

PECOS Enrollment

This provider is enrolled in PECOS as KEVIN OSBORN.

Based on the most recent information from CMS, provider Kevin Christopher Osborn is legally eligible to order and refer claims for DME services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1073564084
Provider Type
Individual
Full Name
Osborn, Kevin Christopher
Title
Dr.

Credential
D.D.S.
Gender
Male
Enumeration Date
5/15/2006
Last Updated
7/8/2007

Contact Information

Practice Location

2451 Jamacha Rd, Suite 104, El Cajon, CA 92019-4324

(619) 444-0500

(619) 444-2803

Mailing Location

2451 Jamacha Rd, Suite 104, El Cajon, CA 92019-4324

(619) 444-0500

(619) 444-2803

Provider Taxonomies

Code	Description	License
Code 1223G0001X Primary	Description Dentist Dental Providers	License 42866 California

Kevin Christopher Osborn

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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