MR. KEITH GLENN KENWORTHY (NPI# 1871831453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871831453 |
| Entity Type | Individual |
| Full Name | MR. KEITH GLENN KENWORTHY |
| Credential | LVN,PHLEBOTOMIST |
| Practice Address |
1764 N Orange Dr Los Angeles CA 90028-4307 |
| Practice Telephone | 3234914765 |
| Mailing Telephone | 3234914765 |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2013-01-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 164X00000X | Licensed Vocational Nurse | VN 267760 | CA | Nursing Service Providers |
| Y | 246RP1900X |
Technician, Pathology Specialization: Phlebotomy |
CPT00040181 | CA | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
1764 N ORANGE DR |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90028-4307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154929859 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5500 W Sunset Blvd, Los Angeles, CA 90028 | 2020-10-14 |
| 1558993527 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 5500 West Sunset Boulevard, Los Angeles, CA 90028 | 2020-02-07 |
| 1639715030 | Michelle Jennifer Martinez | Case Manager/Care Coordinator | 6838 Sunset Blvd., Hollywood, CA 90028 | 2019-11-20 |
| 1821562315 | Ronnie Jerome Jackson | Case Manager/Care Coordinator | Bhs Hollywood Recovery Center, 6838 Sunset Blvd, Hollywood, CA 90028 | 2019-01-17 |
| 1669961595 | Danielle Arce | Dietitian, Registered | 6721 De Longpre Ave, Los Angeles, CA 90028 | 2018-05-07 |
| 1982124772 | Yoon Kyung Lee | Pharmacist | 7201 Hollywood Blvd, Los Angeles, CA 90028 | 2017-06-22 |
| 1982133245 | Julia West | Pharmacist | 6201 Hollywood Blvd #126, Los Angeles, CA 90028 | 2017-06-08 |
| 1720527971 | Melissa Susac | Marriage & Family Therapist | 1540 Schrader Blvd, Garden Suite 12, Hollywood, CA 90028 | 2017-02-21 |
| 1023554284 | Arlene Aranda | Social Worker | 1873 Taft Ave, Los Angeles, CA 90028 | 2017-01-12 |
| 1912304775 | Damon Dodge | Marriage & Family Therapist | 7083 Hollywood Blvd, Los Angeles, CA 90028 | 2014-11-21 |
| Find all providers in zip 90028 | ||||
| Taxonomy Code | 246RP1900X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Technician, Pathology |
| Specialization | Phlebotomy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376151217 | Marco Dimailig | Technician, Pathology | 624 S Berendo St Apt 404, Los Angeles, CA 90005-1749 | 2020-07-16 |
| 1235759788 | Juan Jimenez Jr. | Technician, Pathology | 1860 E 120th St, Los Angeles, CA 90059 | 2020-04-24 |
| 1083866891 | Kenside Medical Services | Technician, Pathology | 4833 10th Ave, Los Angeles, CA 90043-4810 | 2008-10-13 |
| 1811142284 | Ricardo Inez | Technician, Pathology | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2008-11-26 |
| 1518159375 | Lajpat R Chowdhry | Technician, Pathology | 221 West Wood Plaza, Suite#371, Los Angeles, CA 90095-0001 | 2007-08-15 |
| 1699982512 | Harold Kibble | Technician, Pathology | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071882 | Gerardo Quinones Sr. | Technician, Pathology | 839 Illinois Ave., Colton, CA 92324-9232 | 2020-10-19 |
| 1467065300 | Rachel Perez | Technician, Pathology | 12569 Avenue 80, Pixley, CA 93256-9715 | 2020-08-29 |
| 1619586930 | Onestop Mobile Phlebotomy | Technician, Pathology | 4214 E Los Angeles Ave Apt 2, Simi Valley, CA 93063-3373 | 2020-07-23 |
| 1033735535 | Gentle Butterfly Phlebotomy Services LLC | Technician, Pathology | 568 Hacienda Ave, Perris, CA 92571-2810 | 2020-06-19 |
| 1861016958 | Jonathan Godes | Technician, Pathology | 878 Compass Way, San Diego, CA 92154-5839 | 2020-06-03 |
| 1467076067 | Darlene Bennett | Technician, Pathology | 8450 Carob St, Fontana, CA 92335-1221 | 2020-05-31 |
| 1699395202 | Tanya M Atelian | Technician, Pathology | 195 E Mountain Dr, Santa Barbara, CA 93108-1025 | 2020-04-23 |
| 1811528490 | Pamela L Carter | Technician, Pathology | 27668 Dogwood St, Murrieta, CA 92562-4377 | 2020-01-31 |
| 1376191031 | Napoleon Del Rosario | Technician, Pathology | 4899 Willow Rd Apt 415, Pleasanton, CA 94588-4778 | 2019-08-27 |
| 1043862089 | Eli Klouvi | Technician, Pathology | 1795 Hardt St, Loma Linda, CA 92354-1721 | 2019-07-10 |
| Find all providers with the same taxonomy | ||||
| City | LOS ANGELES |
| Zip Code | 90028 |
Please comment or provide details below to improve the information on MR. KEITH GLENN KENWORTHY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.