Provider Demographics
NPI:1235219031
Name:KEENE, DAVID HAL (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HAL
Last Name:KEENE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3721 S LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-5309
Mailing Address - Country:US
Mailing Address - Phone:323-730-1920
Mailing Address - Fax:323-373-2045
Practice Address - Street 1:3721 S LA BREA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-5309
Practice Address - Country:US
Practice Address - Phone:323-730-1920
Practice Address - Fax:323-373-2045
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2024-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG51024208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF01549Medicare UPIN