=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497995963
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DAVID H. KEENE M.D.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/24/2009
-----------------------------------------------------
Last Update Date | 02/24/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9033 WILSHIRE BLVD STE 300
-----------------------------------------------------
City | BEVERLY HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90211-1846
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-273-0330
-----------------------------------------------------
Fax | 310-273-9330
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9033 WILSHIRE BLVD STE 300
-----------------------------------------------------
City | BEVERLY HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90211-1846
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-273-0330
-----------------------------------------------------
Fax | 310-273-9330
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BILLING/OFFICE MANAGER
-----------------------------------------------------
Name | GINNETTE SANDERS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 310-273-0330
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------