Individual
KENNETH DAVID ILLINGWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(310) 423-9900
Mailing address
4140 W 190TH ST, TORRANCE, CA 90504-5513
(310) 967-1780
(866) 991-4287
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
125.061286
IL
207X00000X
Orthopaedic Surgery Physician
Primary
A147674
CA
Other
Enumeration date
07/18/2012
Last updated
05/27/2021
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