Keola MD Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

KEOLA MD INC

Practice address

10941 Bloomfield St Ste G
Los Alamitos, CA 90720-6708

Phone

(714) 406-8698

NPI assigned

Oct 24, 2024

Organization subpart

No

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

Authorized official

Name

Kelly Nguyen

Title

Ceo

Phone

(714) 406-8698

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Jack Rubin, M.D.

  • Internal Medicine Physician
  • Los Alamitos, CA
  • NPI 1700882479

  Nephrology

  Medicare reassignment NPD
• Dao Xuan Nguyen, PHARM.D.

  • Pharmacist
  • Los Angeles, CA
  • NPI 1558617886
  NPD

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1760204432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10941 BLOOMFIELD ST STE G",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907206708",
            "telephone_number": "714-406-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10941 BLOOMFIELD ST STE G",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907206708",
            "telephone_number": "714-406-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEOLA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-406-8698"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa J Kedwards, D.C.
• Peter F Keenan III, MD
• Felicia Lynette Kelley, PT, DPT
• Alona Kellick
• Ian Kent
• Carly Kessenich
• Kevin Chan Chiropractic Corporation
• Khant Dental Corporation
• Htet Khant, DDS
• Khiev Aspiring Wellness Chiropractic

• Nephrology Physician in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.