Individual
KENNY CHAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1250 16TH ST, SANTA MONICA, CA 90404-1249
(310) 794-0585
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1014728
MA
207P00000X
Emergency Medicine Physician
Primary
A205006
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2018
Last updated
07/02/2026
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