Provider Demographics
NPI:1720029481
Name:MURRAY, KENNETH D (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:D
Last Name:MURRAY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:777 FLOWER ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-3015
Mailing Address - Country:US
Mailing Address - Phone:818-637-2000
Mailing Address - Fax:818-242-8761
Practice Address - Street 1:2061 W ALAMEDA AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2932
Practice Address - Country:US
Practice Address - Phone:818-295-5920
Practice Address - Fax:818-295-6965
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2007-09-21
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Provider Licenses
StateLicense IDTaxonomies
CAG50230207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G502300Medicaid
CAA51611Medicare UPIN