Most Relevant Information
Provider Data
| NPI Number: | 1003332909 |
| Provider Name: | KENN RAFANAN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 95006905 |
Most Important Dates
| Enumeration Date: | 08/22/2017 |
| Last Updated: | 10/24/2019 |
Provider Practice Location
2101 ROSECRANS AVE # 3230
EL SEGUNDO
CA
902454749
Practice Location Phone/Fax
| Phone: | 3236288671 |
| Fax: |
Provider Mailing Location
1723 BONANZA AVE
SIMI VALLEY
CA
930635803
Provider Mailing Phone/Fax
| Phone: | 18187302452 |
| Fax: |