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MICHAEL I KELLER M.D. INC NPI 1861593063


NPI Information

NPI: 1861593063
Provider Name: MICHAEL I KELLER M.D. INC

Doing Business As: SAN DIEGO ARTHRITIS MEDICAL CLINIC

Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 03D1105617

Address:
3633 CAMINO DEL RIO S
#300
SAN DIEGO, CA
ZIP 92108
Phone: (619) 287-9730
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MICHAEL I KELLER M.D. INC is a specialist in San Diego, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MICHAEL I KELLER M.D. INC NPI is 1861593063. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As San Diego Arthritis Medical Clinic.

The provider's business location address is:

3633 CAMINO DEL RIO S
#300
SAN DIEGO, CA
ZIP 92108-011
Phone: (619) 287-9730
Fax: (619) 287-4516

The provider's authorized official is Michael Ira Keller .
The authorized official title is President and has the following contact phone number (619) 287-9730.

The CLIA number assigned to this NPI record is 03D1105617 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/26/2006 and was last updated on 8/27/2010.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistG28715CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR0104521MEDICAIDCALIFORNIA
2W6392AMEDICARE PINCALIFORNIA
3GR0104522MEDICAIDCALIFORNIA
4Z79137MEDICARE PINARIZONA
5W6392MEDICARE PINCALIFORNIA
6GR0104523MEDICAIDCALIFORNIA
7GR0104520MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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