Active NPI
Keith E Kenyon Jr., MD
- Ophthalmology Physician
- Los Angeles, CA
National Provider Identifier
1386637528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- G30715
- Practice address
- 201 S Alvarado St
Suite 406
Los Angeles, CA 90057-2320 - Phone
- (213) 483-2416
- Fax
- (213) 483-8211
- NPI assigned
- Aug 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | G30715 | CA | Primary |
Addresses
Primary practice location
201 S Alvarado St
Suite 406
Los Angeles, CA 90057-2320
Mailing address
201 S Alvarado St
Suite 406
Los Angeles, CA 90057-2320
Phone (213) 483-2416
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G307150 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30715 | CA | MD | Dentist |
| G30715 | CA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1386637528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 S ALVARADO ST",
"address_2": "SUITE 406",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900572320",
"telephone_number": "213-483-2416",
"fax_number": "213-483-8211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 S ALVARADO ST",
"address_2": "SUITE 406",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900572320",
"telephone_number": "213-483-2416",
"fax_number": "213-483-8211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENYON",
"first_name": "KEITH",
"middle_name": "E",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-23",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "G30715",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G307150",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.