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NPI Code Detail

MEDICARE: LYNN ANNETTE KEENAN M.D.

MEDICARE: LYNN ANNETTE KEENAN M.D.
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
1207RS0012XSleep Medicine (Internal Medicine) PhysicianG71333CA
2207R00000XInternal Medicine PhysicianG71333CA

General Provider Information

NPI Number : 1528176500
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNN ANNETTE KEENAN M.D.
Provider Business Mailing Address
First Line : 2625 E DIVISADERO ST
Second Line :
City : FRESNO
State : CA
Zip : 93721-1431
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6733 N WILLOW AVE STE 107
Second Line :
City : FRESNO
State : CA
Zip : 93710-5953
Country : US
Telephone Number : 559-435-4700
Fax Number : 559-298-7951
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 02/02/2021

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