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NPI Code Detail

MEDICARE: ANDREW J. KEITH D.C.

MEDICARE: ANDREW J. KEITH D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NN1001XNutrition Chiropractor015972CA

General Provider Information

NPI Number : 1003909409
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW J. KEITH D.C.
Provider Business Mailing Address
First Line : 2361 S AZUSA AVE
Second Line :
City : WEST COVINA
State : CA
Zip : 91792-1537
Country : US
Telephone Number : 626-965-2334
Fax Number : 626-964-6504
Provider Business Practice Location Address
First Line : 2361 S AZUSA AVE
Second Line :
City : WEST COVINA
State : CA
Zip : 91792-1537
Country : US
Telephone Number : 626-965-2334
Fax Number : 626-964-6504
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2006
Last Update Date : 07/08/2007

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