MEDICARE: DOLORES R. KENT, M.D.,INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	G35258	CA

General Provider Information

NPI Number	:	1154521268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOLORES R. KENT, M.D.,INC.

Provider Business Mailing Address
First Line	:	9201 W SUNSET BLVD STE 416
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90069-3705
Country	:	US
Telephone Number	:	310-860-9490
Fax Number	:

Provider Business Practice Location Address
First Line	:	9201 W SUNSET BLVD STE 416
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90069-3705
Country	:	US
Telephone Number	:	310-860-9490
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. DOLORES R. KENT
Credential	:	M.D.
Telephone Number	:	310-860-9490

Provider Enumeration Date	:	07/18/2007
Last Update Date	:	07/18/2007

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