Individual provider Active NPI

Joseph W Keichline, M.D.

  • Family Medicine Physician
  • Long Beach, CA
National Provider Identifier
1467540765
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A43211 Issued in CA
Practice address
2360 Pacific Ave
Long Beach, CA 90806-3051
Phone
(562) 981-6856
Fax
(562) 981-6851
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A43211 CA Primary

Addresses

Primary practice location

2360 Pacific Ave
Long Beach, CA 90806-3051

Mailing address

2360 Pacific Ave
Long Beach, CA 90806-3051
Phone (562) 981-6856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151208001617 CA Order and Referring Only - Family PracticePractitioner - Family Practice 5890856249

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43211CAMDLicensed Psychiatric Technician

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1467540765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908063051",
            "telephone_number": "562-981-6856",
            "fax_number": "562-981-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908063051",
            "telephone_number": "562-981-6856",
            "fax_number": "562-981-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEICHLINE",
        "first_name": "JOSEPH",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A43211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.