Active NPI
Diane Keilberg, RPH
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Inglewood, CA
National Provider Identifier
1760847669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- RPH 46888
- Practice address
- 721 S Glasgow Ave
Ste C
Inglewood, CA 90301-3014 - Phone
- (310) 665-1121
- Fax
- (310) 665-1141
- NPI assigned
- Dec 18, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | RPH 46888 | CA | Primary |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 29691 | TX | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | S020148 | AZ | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 18683 | NV | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | RPH-0015109 | OR |
Addresses
Primary practice location
721 S Glasgow Ave
Ste C
Inglewood, CA 90301-3014
Mailing address
1902 W 237TH St
Torrance, CA 90501-6104
Phone (310) 961-0772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29691 | TX | MD | General Practice Dentistry |
| S020148 | AZ | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| RPH 46888 | CA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 18683 | NV | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| RPH-0015109 | OR | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450396800000",
"number": "1760847669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1902 W 237TH ST",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905016104",
"telephone_number": "310-961-0772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 S GLASGOW AVE",
"address_2": "STE C",
"city": "INGLEWOOD",
"state": "CA",
"postal_code": "903013014",
"telephone_number": "310-665-1121",
"fax_number": "310-665-1141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEILBERG",
"first_name": "DIANE",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-18",
"last_updated": "2015-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "CA",
"license": "RPH 46888",
"primary": true
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "TX",
"license": "29691",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "AZ",
"license": "S020148",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "NV",
"license": "18683",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "OR",
"license": "RPH-0015109",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Inglewood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.