Organization
KENNETH SUBOTNIK, PH.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH LEE SUBOTNIK PH.D. (DIRECTOR)
(310) 824-4600
Entity
Organization
Contact information
Practice address
10850 WILSHIRE BLVD STE 240, LOS ANGELES, CA 90024-4308
(310) 824-4600
Mailing address
10850 WILSHIRE BLVD STE 240, LOS ANGELES, CA 90024-4308
(310) 824-4600
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
PSY12770
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY12770
CALIFORNIA PSYCHOLOGIST LICENSE
CA
05
—
PSY127700
—
CA
Enumeration date
06/02/2008
Last updated
06/02/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up