Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 19411 | NV |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | A133422 | CA |
N | 2081P2900X | Pain Medicine | A133422 | CA |
NPI | 1174866107 |
---|---|
Provider Name | Dr. Richard W Keyme |
First Address | San Jose, CA 95124-6350 |
Second Address | San Jose, CA 95124-6350 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2013 |
Last Update Date | 11/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A133422 | CALIFORNIA MEDICAL LICENSE (01) | CA |