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NPI 1174866107

NPI 1174866107 : RICHARD W KEYME MD : SAN JOSE, CA

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General NPI Number Information
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    NPI Number           |    1174866107
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    Entity Type          |    Individual 
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    Provider Name        |    RICHARD W KEYME MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/27/2013
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    Last Update Date     |    07/21/2022
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Provider Practice Location Address
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    Address Line         |    1604 BLOSSOM HILL RD STE 10 
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    City                 |    SAN JOSE
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    State                |    CA
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    Zip                  |    95124-6350
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    Country              |    US
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    Telephone            |    408-528-8833
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1604 BLOSSOM HILL RD STE 10 
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    City                 |    SAN JOSE
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    State                |    CA
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    Zip                  |    95124-6350
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    Country              |    US
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    Telephone            |    408-528-8833
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    Fax                  |    408-827-4171
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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        |    208100000X
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    Taxonomy Name        |    Physical Medicine & Rehabilitation Physician
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    License Number       |    19411
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    License Number State |    NV
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Taxonomy #2
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    Taxonomy Code        |    2081P0301X
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    Taxonomy Name        |    Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
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    License Number       |    A133422
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    License Number State |    CA
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Taxonomy #3
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    Taxonomy Code        |    2081P2900X
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    Taxonomy Name        |    Pain Medicine (Physical Medicine & Rehabilitation) Physician
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    License Number       |    A133422
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    License Number State |    CA
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Taxonomy #4
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    Taxonomy Code        |    208100000X
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    Taxonomy Name        |    Physical Medicine & Rehabilitation Physician
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    License Number       |    A133422
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    License Number State |    CA
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