IndividualActive
Praveen Kambam, M.D.
NPI 1912034141 · Forensic Psychiatry Physician · Los Angeles, CA
Provider details
- NPI number
- 1912034141
- Entity type
- Individual
- Primary specialty
- Forensic Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- A100457 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
11500 W Olympic Blvd
538
Los Angeles, CA 90064
Phone: (310) 231-8964
Fax: (310) 627-1657
Approximate (ZIP-level) locationGet directions
Mailing address
644 N Fuller Ave Pmb 7190
Los Angeles, CA 90036-1939
Registry dates
- Enumerated
- 2007-02-27
- Last updated
- 2020-11-23
- Certified
- 2020-11-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.