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Individual

IVANNA LYNN KENWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
2001 SANTA MONICA BLVD STE 1060, SANTA MONICA, CA 90404-2130
(310) 582-1940
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5799
CA
390200000X
Student in an Organized Health Care Education/Training Program
EL6932
CA

Other

Enumeration date
07/24/2019
Last updated
09/07/2022
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