Organization
KEITH EARL KENYON JR MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH EARL KENYON JR. M.D. (PRESIDENT)
(213) 483-2416
Entity
Organization
Contact information
Practice address
201 S ALVARADO ST, SUITE 406, LOS ANGELES, CA 90057-2320
(213) 483-2416
(213) 483-8211
Mailing address
201 S ALVARADO ST, SUITE 406, LOS ANGELES, CA 90057-2320
(213) 483-2416
(213) 483-8211
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G30715
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G307150
—
CA
Enumeration date
02/08/2011
Last updated
02/08/2011
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