# KEITH O KIELMEYER MD PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184878340
- **Authorized official:** DR. KEITH O KIELMEYER M.D. (PRESIDENT)
- **Authorized official phone:** (559) 970-3411

## Contact information

- **Practice address:** 5536 E LANE AVE, FRESNO, CA 93727-5336
- **Practice address phone:** (559) 970-3411
- **Mailing address:** 5536 E LANE AVE, FRESNO, CA 93727-5336
- **Mailing address phone:** (559) 970-3411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | C35402 | CA | Yes |

## Other

- **Enumeration date:** 11/13/2008
- **Last updated:** 05/26/2009