Sparks, Kenneth O

Sparks, Kenneth O is an sole proprietor health care provider with primary practice located at 8383 Wilshire Blvd Suite 440, Beverly Hills CA 90211-2425. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Sparks, Kenneth O can be contacted via phone (323) 655-8036.

Contact Information

Primary practice address
8383 Wilshire Blvd Suite 440 Beverly Hills CA 90211-2425
Phone: (323) 655-8036
Fax: (323) 655-8443
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X G39756 California

Profile Details

NPI number 1598790263
LBN Legal business name Sparks, Kenneth O
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 11th, 2006
Last updated Jun 18th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598790263 NPPES
California MEDICAID 00G397560

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