Provider Demographics
NPI:1225302755
Name:KENAN, JOSEPH NAYLOR (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:NAYLOR
Last Name:KENAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12424 WILSHIRE BLVD STE 1130
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1064
Mailing Address - Country:US
Mailing Address - Phone:131-038-3177
Mailing Address - Fax:
Practice Address - Street 1:12424 WILSHIRE BLVD STE 1130
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1064
Practice Address - Country:US
Practice Address - Phone:310-383-1776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-01
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0660802084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry