Provider Demographics
NPI:1083863690
Name:LI, KEVIN K (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:K
Last Name:LI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2555 E COLORADO BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-6648
Mailing Address - Country:US
Mailing Address - Phone:626-538-8950
Mailing Address - Fax:626-566-7620
Practice Address - Street 1:2555 E COLORADO BLVD STE 306
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-6648
Practice Address - Country:US
Practice Address - Phone:626-538-8950
Practice Address - Fax:626-566-7620
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2021-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA100695207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology