Healthcare Provider Details

I. General information

NPI: 1962445213
Provider Name (Legal Business Name): CURTIS WILLIAM KESWICK O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 02/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 MIRANDA AVE
PALO ALTO CA
94304-1207
US

IV. Provider business mailing address

3801 MIRANDA AVE
PALO ALTO CA
94304-1207
US

V. Phone/Fax

Practice location:
  • Phone: 650-493-5000
  • Fax: 650-849-0145
Mailing address:
  • Phone: 650-493-5000
  • Fax: 650-849-0145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number5889T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: