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General NPI Number Information
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NPI Number | 1285755496
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Entity Type | Organization
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Legal Business Name | WILLIAM DANIEL KEITH JR MD INC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/10/2018
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Provider Practice Location Address
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Address Line | 6200 WILSHIRE BLVD SUITE 1111
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City | LOS ANGELES
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State | CA
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Zip | 90048
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Country | US
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Telephone | 323-932-0382
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Fax | 323-932-0653
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Provider Business Mailing Address
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Address Line | 6200 WILSHIRE BLVD SUITE 1111
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City | LOS ANGELES
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State | CA
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Zip | 90048-5801
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Country | US
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Telephone | 323-932-0382
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Fax | 323-932-0653
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. WILLIAM DANIEL KEITH JR.
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Credential | M.D.
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Telephone | 323-932-0382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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