Healthcare Provider Details

I. General information

NPI: 1609856863
Provider Name (Legal Business Name): JEFFREY JAY KEYTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 FRANKLIN AVE
LEMOORE CA
93246-0001
US

IV. Provider business mailing address

3043 HELLCAT CT
LEMOORE CA
93245-2218
US

V. Phone/Fax

Practice location:
  • Phone: 559-998-4461
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA88834
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: