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Organization

ROBERT J. MCKENNA JR. MD, A MEDICAL CORPORATION

Active
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Organization

ROBERT J. MCKENNA JR. MD, A MEDICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT JOSEPH MCKENNA JR. MD (PHYSICIAN)
(310) 652-0530
Entity
Organization

Contact information

Practice address
8635 W THIRD STREET, NO 975W, LOS ANGELES, CA 90048-6101
(310) 652-0530
(310) 652-9936
Mailing address
8635 W THIRD STREET, NO 975W, LOS ANGELES, CA 90048-6101
(310) 652-0530
(310) 652-9936

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G39081
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0091070
—
CA
Enumeration date
01/22/2007
Last updated
10/11/2007
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