Keith Earl Kenyon Jr MD Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G30715 Issued in CA

Legal business name

KEITH EARL KENYON JR MD INC

Practice address

201 S Alvarado St
Suite 406
Los Angeles, CA 90057-2320

Phone

(213) 483-2416

Fax

(213) 483-8211

NPI assigned

Feb 8, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Keith Earl Kenyon Jr., M.D.

Title

President

Phone

(213) 483-2416

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1225334360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S ALVARADO ST",
            "address_2": "SUITE 406",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572320",
            "telephone_number": "213-483-2416",
            "fax_number": "213-483-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S ALVARADO ST",
            "address_2": "SUITE 406",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572320",
            "telephone_number": "213-483-2416",
            "fax_number": "213-483-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH EARL KENYON JR MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "KENYON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-483-2416",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G30715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G307150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Audrey Anne Keim, MD
• Robert Gerald Keim, D.D.S.
• Dorothy Keiper
• Susan Jennifer Keiper, FNP
• Keiro Nursing Home
• Keith L Agre, MD, Medical Corporation
• Keith L. Gurnick, D.P.M.
• Averi Keith
• William Daniel Keith Jr., M.D. , INC.
• Keivan Sarraf, DDS, Inc

• Ophthalmology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Ophthalmology Physician in California

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