Active NPI
Keith McDaniel, M.D.
- Psychiatry Physician
- Oakland, CA
National Provider Identifier
1174531545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- C40008
- Practice address
- 2633 E 27TH St
Oakland, CA 94601-1912 - Phone
- (510) 534-5202
- NPI assigned
- Aug 3, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | C40008 | CA | Primary |
Addresses
Primary practice location
2633 E 27TH St
Oakland, CA 94601-1912
Mailing address
PO Box 74515
Davis, CA 95617-5515
Phone (530) 758-9628
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C40008 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174531545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 74515",
"city": "DAVIS",
"state": "CA",
"postal_code": "956175515",
"telephone_number": "530-758-9628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2633 E 27TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946011912",
"telephone_number": "510-534-5202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDANIEL",
"first_name": "KEITH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "C40008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.