Individual
MR. KEVIN CHIBOUZO ILO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1225 15TH ST STE 2100, SANTA MONICA, CA 90404-1101
(310) 319-1234
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
SPI829
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/02/2023
Last updated
09/27/2024
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