Individual
DR. ROBERT JOSEPH MCKENNA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2121 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2303
(310) 829-8618
(310) 829-8607
Mailing address
400 S WINDSOR BLVD, LOS ANGELES, CA 90020-4714
(424) 272-0337
(310) 861-5508
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G39081
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G390810
—
CA
Enumeration date
08/09/2006
Last updated
04/19/2021
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