MEDICARE: DR. LAURA O'KEEFE D.V.M

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174M00000X	Veterinarian	VET10035	CA

General Provider Information

NPI Number	:	1356718498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA O'KEEFE D.V.M

Provider Business Mailing Address
First Line	:	4791 EDGARTOWN DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-6436
Country	:	US
Telephone Number	:	703-872-9946
Fax Number	:

Provider Business Practice Location Address
First Line	:	4791 EDGARTOWN DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-6436
Country	:	US
Telephone Number	:	703-872-9946
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2015
Last Update Date	:	08/24/2015

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