Individual
KENISHA AKEILA NISBETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1513 S GRAND AVE STE 200, LOS ANGELES, CA 90015-3075
(323) 438-0483
(310) 862-6817
Mailing address
122 S GREEN ST STE 5, TEHACHAPI, CA 93561-1717
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A17194
CA
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
17194
CA
Other
Enumeration date
04/13/2017
Last updated
05/20/2024
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