Individual
KENNETH RICHARD SCACCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3828 DELMAS TER, CULVER CITY, CA 90232-2713
(310) 945-3350
Mailing address
9808 VENICE BLVD STE 700, CULVER CITY, CA 90232-6824
(310) 945-3350
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
CA
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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