Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 1003234691 | IL |
Y | 208000000X | Pediatrician | 20A17739 | CA |
NPI | 1003234691 |
---|---|
Provider Name | Dr. Kenan Mohammed Nadar |
First Address | Torrance, CA 90504-5513 |
Second Address | West Hollywood, CA 90048-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2014 |
Last Update Date | 17/08/2020 |