Provider Demographics
NPI:1043281074
Name:KEENAN, JOANNE PATRICIA (DO)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:PATRICIA
Last Name:KEENAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6719 ALVARADO RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-5254
Mailing Address - Country:US
Mailing Address - Phone:619-286-8804
Mailing Address - Fax:619-286-2344
Practice Address - Street 1:6719 ALVARADO RD
Practice Address - Street 2:SUITE 108
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-5254
Practice Address - Country:US
Practice Address - Phone:619-286-8804
Practice Address - Fax:619-286-2344
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A 8728207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine