Search › California › 374U00000X
Miracle Kennon
NPI 1417403163 · on the registry since 2016
Practice
- Address
- 711 W 54th St
Los Angeles, CA 90037 - Phone
- (323) 593-1035
Registry record
- Primary taxonomy
- 374U00000X
374U00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2016-08-31
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California