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1215139647
KENNETH BERTRAM ELCONIN
LOS ANGELES, CA
NPI
1215139647
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QU0200X Clinic/Center, Urgent Care
(Licence: CA afe17621)
Enumeration Date
2007-06-05
Last Update Date
2007-07-18
Business Address
Dr. KENNETH BERTRAM ELCONIN M.D.
8405 BEVERLY BLVD
LOS ANGELES, CA 90048-3401
Phone number: 323-653-8622
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Mailing Address
Dr. KENNETH BERTRAM ELCONIN M.D.
500 HOMEWOOD RD
LOS ANGELES, CA 90049-1906
Phone number: 310-472-2983
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