Healthcare Provider Details

I. General information

NPI: 1982133435
Provider Name (Legal Business Name): KEERAT DHATT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6505 S MANTHEY RD
FRENCH CAMP CA
95231-9518
US

IV. Provider business mailing address

5274 TUDOR ROSE GLN
STOCKTON CA
95212-9272
US

V. Phone/Fax

Practice location:
  • Phone: 209-946-3400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA170252
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: