Healthcare Provider Details

I. General information

NPI: 1558274324
Provider Name (Legal Business Name): KEEGAN FABRI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 1ST AVE
SAN DIEGO CA
92101-1596
US

IV. Provider business mailing address

2160 BRANT ST
SAN DIEGO CA
92101-1808
US

V. Phone/Fax

Practice location:
  • Phone: 619-333-1050
  • Fax:
Mailing address:
  • Phone: 405-230-6381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC37750
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: