Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | G54893 | CA |
NPI | 1346292539 |
---|---|
Provider Name | Dr. Darrel Brent Keyser |
First Address | Hayward, CA 94545-4300 |
Second Address | Hayward, CA 94545-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E64878 | (02) | CA |