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General NPI Number Information
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NPI Number | 1356393656
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Entity Type | Individual
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Provider Name | DAVID LOUIS KELLER MD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 06/22/2020
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Provider Practice Location Address
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Address Line | 1948 ROLLING VISTA DR
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City | LOMITA
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State | CA
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Zip | 90717-3769
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Country | US
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Telephone | 310-896-5435
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Fax | 888-313-1539
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Provider Business Mailing Address
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Address Line | PO BOX 1172
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City | LOMITA
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State | CA
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Zip | 90717-5172
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Country | US
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Telephone | 310-906-0651
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Fax | 888-313-1539
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G77409
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License Number State | CA
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