Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Charles Derensbough Kennedy, MD

Individual provider Internal Medicine Physician · NPI 1942576111

Dr. Charles Derensbough Kennedy, MD is an Internal Medicine Physician in Simi Valley, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2012
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

229 Sycamore Grove St
Simi Valley, CA 93065-7342
Phone: (805) 217-6724
Fax: (805) 217-6724
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence G066894 (CA)

Record details

NPI number1942576111
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 31, 2012
Last updated in NPPESMarch 31, 2012

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