Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | C136632 | CA |
NPI | 1043283997 |
---|---|
Provider Name | Dr. Kenneth R Hallows |
First Address | Los Angeles, CA 90089-0121 |
Second Address | Los Angeles, CA 90089-0121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 19/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001861031 | (05) | PA |
H49074 | (02) | PA |