MEDICARE: JULIE A KEELER DO INC

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
1	207Q00000X	Family Medicine Physician	20A9655	CA

General Provider Information

NPI Number	:	1851602254
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULIE A KEELER DO INC

Provider Business Mailing Address
First Line	:	771 JAMACHA RD
Second Line	:	#257
City	:	EL CAJON
State	:	CA
Zip	:	92019-3202
Country	:	US
Telephone Number	:	619-272-4222
Fax Number	:	619-272-4222

Provider Business Practice Location Address
First Line	:	771 JAMACHA RD (NO OFFICE - HOUSECALLS ONLY)
Second Line	:	#257
City	:	EL CAJON
State	:	CA
Zip	:	92019-3202
Country	:	US
Telephone Number	:	619-272-4222
Fax Number	:	619-272-4222

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JULIE A KEELER
Credential	:	DO
Telephone Number	:	619-272-4222

Provider Enumeration Date	:	06/30/2010
Last Update Date	:	06/30/2010

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