Most Relevant Information
Provider Data
| NPI Number: | 1003376716 |
| Provider Name: | KEN DEKITANI |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/20/2019 |
| Last Updated: | 05/07/2024 |
Provider Practice Location
757 WESTWOOD PLZ
LOS ANGELES
CA
900958358
Practice Location Phone/Fax
| Phone: | 3102677849 |
| Fax: |
Provider Mailing Location
757 WESTWOOD PLZ
LOS ANGELES
CA
900957419
Provider Mailing Phone/Fax
| Phone: | 3102677849 |
| Fax: |