Provider Demographics
NPI:1811131741
Name:KENNETH J. ARENSON, M.D.
Entity type:Organization
Organization Name:KENNETH J. ARENSON, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-340-5600
Mailing Address - Street 1:7301 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE #410
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1904
Mailing Address - Country:US
Mailing Address - Phone:818-340-5600
Mailing Address - Fax:818-340-5650
Practice Address - Street 1:7301 MEDICAL CENTER DR
Practice Address - Street 2:SUITE #410
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1904
Practice Address - Country:US
Practice Address - Phone:818-340-5600
Practice Address - Fax:818-340-5650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA28845207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4371616Medicaid
CAA83864Medicare UPIN