Healthcare Provider Details
I. General information
NPI: 1376685644
Provider Name (Legal Business Name): LIAM KEATING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 ALHAMBRA AVE
MARTINEZ CA
94553-3156
US
IV. Provider business mailing address
534 GRANDVIEW CT
POINT RICHMOND CA
94801-3746
US
V. Phone/Fax
- Phone: 925-370-5000
- Fax:
- Phone: 925-370-5852
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | G68204 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: