Healthcare Provider Details

I. General information

NPI: 1619970217
Provider Name (Legal Business Name): RALPH KEILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 06/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 WOODSIDE PL
CARMEL VALLEY CA
93924-9545
US

IV. Provider business mailing address

PO BOX 2300
SALINAS CA
93902-2300
US

V. Phone/Fax

Practice location:
  • Phone: 831-659-5124
  • Fax:
Mailing address:
  • Phone: 831-622-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC27407
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: