Healthcare Provider Details

I. General information

NPI: 1346292539
Provider Name (Legal Business Name): DARREL BRENT KEYSER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27206 CALAROGA AVE SUITE 115
HAYWARD CA
94545-4300
US

IV. Provider business mailing address

27206 CALAROGA AVE SUITE 115
HAYWARD CA
94545-4300
US

V. Phone/Fax

Practice location:
  • Phone: 510-259-1201
  • Fax: 510-259-1203
Mailing address:
  • Phone: 510-259-1201
  • Fax: 510-259-1203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License NumberG54893
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: