Provider Demographics
NPI: | 1568556462 |
---|---|
Name: | KEYS, CHRISTOPHER JOSEPH (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | CHRISTOPHER |
Middle Name: | JOSEPH |
Last Name: | KEYS |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 7793 |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN FRANCISCO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 94120-7793 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 503-372-2740 |
Mailing Address - Fax: | 503-372-2754 |
Practice Address - Street 1: | 900 HYDE ST |
Practice Address - Street 2: | |
Practice Address - City: | SAN FRANCISCO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94109-4806 |
Practice Address - Country: | US |
Practice Address - Phone: | 415-353-6000 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-10-03 |
Last Update Date: | 2007-07-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | G71107 | 207L00000X, 207LP2900X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Not Answered | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | |
Not Answered | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | 00G711070 | Medicaid | |
CA | 00G711070 | Medicaid | |
CA | 00G711070 | Medicare ID - Type Unspecified |