Individual
KELSEY L FORD BENCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 N STATE ST, CLINIC TOWER, SUITE A7D, LOS ANGELES, CA 90033-1029
(323) 409-1945
Mailing address
1200 N STATE ST, CLINIC TOWER, SUITE A7D, LOS ANGELES, CA 90033-1029
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD61021863
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2016
Last updated
09/04/2020
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