Healthcare Provider Details

I. General information

NPI: 1578564506
Provider Name (Legal Business Name): KEITH H FIMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2005
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 HAMPTON RD
PIEDMONT CA
94611-3525
US

IV. Provider business mailing address

333 HAMPTON RD
PIEDMONT CA
94611-3525
US

V. Phone/Fax

Practice location:
  • Phone: 713-305-1074
  • Fax:
Mailing address:
  • Phone: 713-305-1074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberH2370
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number14231423-1235
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberG193185
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: