Basic Information
Provider Information
NPI: 1467624908
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KEEFER
FirstName: BRIAN
MiddleName: P
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 16955 VIA DEL CAMPO
Address2: STE 215
City: SAN DIEGO
State: CA
PostalCode: 921271718
CountryCode: US
TelephoneNumber: 8586736100
FaxNumber: 8586736113
Practice Location
Address1: 555 E VALLEY PKWY
Address2:  
City: ESCONDIDO
State: CA
PostalCode: 920253048
CountryCode: US
TelephoneNumber: 7607393000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/25/2008
LastUpdateDate: 12/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA93396CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home