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General NPI Number Information
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NPI Number | 1740238104
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Entity Type | Individual
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Provider Name | KEITH KENNETH VAUX MD
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Gender | Male
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 617 BROADWAY UNIT 120
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City | SONOMA
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State | CA
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Zip | 95476-2402
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Country | US
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Telephone | 619-777-8321
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Fax | 858-345-5019
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Provider Business Mailing Address
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Address Line | 617 BROADWAY UNIT 120
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City | SONOMA
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State | CA
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Zip | 95476-2402
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Country | US
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Telephone | 619-750-8289
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Fax | 858-345-5019
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A87297
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A87297
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | A87297
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License Number State | CA
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