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Individual
DR. KEITH L SEIDENSTRICKER
Active
Individual
DR. KEITH L SEIDENSTRICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G247060
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G247060
STATE LICENSE #
CA
01
—
GR0092950
MEDI-CAL GROUP #
CA
01
—
ZZZ01707Z
MEDICARE GROUP #
CA
01
—
ZZZ01800Z
BLUE SHIELD GROUP PROV#
CA
Enumeration date
12/26/2006
Last updated
02/22/2013
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