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General NPI Number Information
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NPI Number | 1124243134
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Entity Type | Individual
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Provider Name | KEITH A. CORL MD
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Gender | Male
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 1700 PRAIRIE CITY RD
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City | FOLSOM
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State | CA
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Zip | 95630-9594
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Country | US
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Telephone | 916-351-4800
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Fax | 916-351-4899
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Provider Business Mailing Address
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Address Line | 3400 DATA DR
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-7956
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | C174320
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | C174320
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD218016
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License Number State | OR
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