Provider Demographics
NPI:1194507632
Name:KEITH T. CHUMLEY ADVISORS, M.D., PC
Entity type:Organization
Organization Name:KEITH T. CHUMLEY ADVISORS, M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHUMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-250-9979
Mailing Address - Street 1:23600 TELO AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4037
Mailing Address - Country:US
Mailing Address - Phone:424-250-9979
Mailing Address - Fax:424-250-9981
Practice Address - Street 1:23600 TELO AVE STE 280
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4037
Practice Address - Country:US
Practice Address - Phone:424-250-9979
Practice Address - Fax:424-250-9981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty