Provider Demographics
NPI:1972675403
Name:BEST, KENNETH REUBEN (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:REUBEN
Last Name:BEST
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 S CLARK DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1438
Mailing Address - Country:US
Mailing Address - Phone:323-655-5515
Mailing Address - Fax:323-655-0860
Practice Address - Street 1:144 S FLORES ST STE A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3518
Practice Address - Country:US
Practice Address - Phone:323-655-5515
Practice Address - Fax:323-655-0860
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23744111NI0900X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV01517Medicare UPIN