KEEN MEDICAL GROUP INC NPI 1174901334

NPI Information

KEEN MEDICAL GROUP INC is an occupational health nurse practitioner in Hesperia, CA. KEEN MEDICAL GROUP INC NPI is 1174901334. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

12021 JACARANDA AVE
SUITE # 101
HESPERIA, CA
ZIP 92345-978
Phone: (760) 956-5057
Fax: (760) 948-2179

The provider's authorized official is Arlene F Braham .
The authorized official title is President and has the following contact phone number (760) 956-5057.

The CLIA number assigned to this NPI record is 05D0971031 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/8/2015 and was last updated on 5/8/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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