Individual
KENNETH IM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1313 W 8TH ST STE 100, LOS ANGELES, CA 90017-4422
(213) 401-1970
Mailing address
13425 BEACHNUTT CT, LA MIRADA, CA 90638-6559
(714) 287-4964
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
02/15/2020
Last updated
02/18/2020
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