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General NPI Number Information
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NPI Number | 1013952159
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Entity Type | Individual
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Provider Name | KENITH K PARESA MD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 11600 WILSHIRE BLVD STE 406
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City | LOS ANGELES
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State | CA
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Zip | 90025-1785
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Country | US
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Telephone | 424-248-8325
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Fax | 310-943-2161
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Provider Business Mailing Address
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Address Line | 11740 SAN VICENTE BLVD # 109440
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City | LOS ANGELES
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State | CA
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Zip | 90049-6610
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Country | US
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Telephone | 310-659-9566
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Fax | 310-360-6777
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | A66233
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License Number State | CA
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