Kenn Rafanan
Nurse Practitioner - Family Medicine
2101 Rosecrans Ave # 3230
El Segundo
, California 90245-4749
Kenn Rafanan
Nurse Practitioner - Family Medicine
2101 Rosecrans Ave # 3230
El Segundo
, California 90245-4749
18187302452
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About
Features
Specialties
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Kenn Rafanan
- 1723 Bonanza Ave
- Simi Valley, CA
- Zip : 93063-5803
- Phone : 18187302452
Second Address
- Kenn Rafanan
- 2101 Rosecrans Ave # 3230
- El Segundo, CA
- Zip : 90245-4749
- Phone : (323) 628-8671
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | 95006905 | CA |
National Provider Identifier
| NPI | 1003332909 |
|---|---|
| Provider Name | Kenn Rafanan |
| First Address | Simi Valley, CA 93063-5803 |
| Second Address | El Segundo, CA 90245-4749 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/08/2017 |
| Last Update Date | 24/10/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.