Keen Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G66379 Issued in CA

Legal business name

KEEN MEDICAL GROUP, INC.

Practice address

12021 Jacaranda Ave
Hesperia, CA 92345-4978

Phone

(760) 956-5057

Fax

(760) 948-2179

NPI assigned

Feb 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Arlene Braham, M.D.NPI 1447362462

Title

President

Phone

(760) 956-5057

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Arlene Braham, MD

  • General Practice Physician
  • Hesperia, CA
  • NPI 1447362462
  NPD (past) Authorized official
• Ben Arnold Adom, NP

  • Registered Nurse
  • Hesperia, CA
  • NPI 1417473034

  Family Medicine

  NPD
• Bryan Andrew Mitton, MD, PHD

  • Pediatrics Physician
  • Hesperia, CA
  • NPI 1063674620
  NPD
• Tanya Antonieta Benitez, FNP

  • Nurse Practitioner
  • Salinas, CA
  • NPI 1164891289
  NPD (past)
• Jonathan Fan Lu, FNP-C

  • Family Medicine Physician
  • Tustin, CA
  • NPI 1043796402
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299110400000",
    "number": "1053456962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12021 JACARANDA AVE",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923454978",
            "telephone_number": "760-956-5057",
            "fax_number": "760-948-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 JACARANDA AVE",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923454978",
            "telephone_number": "760-956-5057",
            "fax_number": "760-948-2179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEEN MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "BRAHAM",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-956-5057",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G66379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0092540",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ64052Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frederick John Katz III
• Anna Jean Kaufer, PTA
• Judy Ann Kaufer, ATC
• Christopher Kawata, DO
• Keen Medical Group Inc
• Trinity Ann Keife
• Maryam Keshmiri, DDS
• Laila Khamsei, DDS
• Bakht-Awar Khan, M.D.
• Amy Kim, D.M.D

• Family Medicine Physician in Hesperia, CA
• Providers in Hesperia, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.