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General NPI Number Information
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NPI Number | 1770670127
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Entity Type | Organization
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Legal Business Name | KENNETH W WRIGHT M D A PROFESSIONAL
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 2410 TORRANCE BLVD STE B
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City | TORRANCE
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State | CA
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Zip | 90501-0401
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Country | US
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Telephone | 310-652-6420
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Fax | 310-946-0363
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Provider Business Mailing Address
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Address Line | 2410 TORRANCE BLVD STE B
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City | TORRANCE
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State | CA
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Zip | 90501-0401
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Country | US
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Telephone | 310-652-6420
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Fax | 310-946-0363
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH W WRIGHT
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Credential | MD
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Telephone | 310-652-6420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G37700
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License Number State | CA
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