Keith William McGill, PHYSICIAN ASSISTANT

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

PA11313 Issued in CA

Practice address

150 S Pico Ave
14342 Bora Dr la Mirada 90638
Long Beach, CA 90802

Phone

(562) 432-2821

Fax

(562) 437-1353

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Agile Occupational Medicine, PC

  • Occupational Medicine Clinic/Center
  • Santa Fe Springs, CA
  • NPI 1710860705
  NPD (past)
• Healthfirst Medical Group of Santa Fe Springs

  • Occupational Medicine Clinic/Center
  • Santa Fe Springs, CA
  • NPI 1760600092
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1629169396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S PICO AVE",
            "address_2": "14342 BORA DRIVE LA MIRADA, CA 90638",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908026247",
            "telephone_number": "562-432-2821",
            "fax_number": "562-437-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S PICO AVE",
            "address_2": "14342 BORA DR LA MIRADA 90638",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90802",
            "telephone_number": "562-432-2821",
            "fax_number": "562-437-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGILL",
        "first_name": "KEITH",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "PA11313",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA 11313",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASST. LICENSE #",
            "identifier": "PA11313",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorna McFarland, MD
• John McGady
• Brejanae McGee
• Madison Elizabeth McGhee
• Milton Emerson McGhee
• Kendra McGivney, LCSW
• Deborah Lynn McGlone, MA, CADC II
• Maureen Bridget McGlynn, LMFT
• Rhonda McGonigle
• Julie McGowan

• Dermatology Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.