NPIMap

Organization Active NPI

Keen Medical Group Inc

  • Occupational Health Nurse Practitioner
  • Hesperia, CA
National Provider Identifier
1174901334
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health Nurse PractitionerTaxonomy code 363LX0106X
License
G066379 Issued in CA
Legal business name
KEEN MEDICAL GROUP INC
Practice address
12021 Jacaranda Ave
Suite # 101
Hesperia, CA 92345-4978
Phone
(760) 956-5057
Fax
(760) 948-2179
NPI assigned
May 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2015

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

Authorized official

Name
Dr. Arlene F Braham, M.D.NPI 1447362462
Title
President
Phone
(760) 956-5057

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LX0106X G066379 CA Primary

Addresses

Primary practice location

12021 Jacaranda Ave
Suite # 101
Hesperia, CA 92345-4978

Mailing address

12021 Jacaranda Ave
Suite # 101
Hesperia, CA 92345-4978
Phone (760) 956-5057

National Provider Directory

National Provider Directory

Locations

12021 Jacaranda Ave
Ste 101
Hesperia, CA 92345
Phone (760) 956-5057

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1174901334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12021 JACARANDA AVE",
            "address_2": "SUITE # 101",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923454978",
            "telephone_number": "760-956-5057",
            "fax_number": "760-948-2179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 JACARANDA AVE",
            "address_2": "SUITE # 101",
            "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": "2015-05-08",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "BRAHAM",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-956-5057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LX0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "CA",
            "license": "G066379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hesperia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; 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.