Healthcare Provider Details

I. General information

NPI: 1285697342
Provider Name (Legal Business Name): KENNETH HUFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 07/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21840 NORMANDIE AVE STE 700
TORRANCE CA
90502-2047
US

IV. Provider business mailing address

21840 NORMANDIE AVE STE 700
TORRANCE CA
90502-2047
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-5189
  • Fax: 310-328-1415
Mailing address:
  • Phone: 310-222-5189
  • Fax: 310-781-9352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberG50874
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: