Individual
PETER SAMUEL KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 S ALVARADO ST, SUITE 110, LOS ANGELES, CA 90057-2320
(213) 484-6474
(213) 484-8470
Mailing address
PO BOX 81172, SAN MARINO, CA 91118-1172
(213) 484-6474
(213) 484-8470
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
C38037
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00380370
—
CA
Enumeration date
04/21/2006
Last updated
05/06/2010
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