Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 103481 | CA |
NPI | 1093243461 |
---|---|
Provider Name | Ankit J Keshav |
First Address | Downey, CA 90240-2169 |
Second Address | Downey, CA 90240-2169 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2017 |
Last Update Date | 26/05/2020 |