# KEY HEALTH MEDICAL GROUP

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

## Provider details

- **NPI number:** 1407061559
- **Authorized official:** DR. WILLIAM GLENN (PRESIDENT)
- **Authorized official phone:** (818) 575-5300

## Contact information

- **Practice address:** 30699 RUSSELL RANCH ROAD, SUITE 175, WESTLAKE VILLAGE, CA 91362
- **Practice address phone:** (818) 575-5300
- **Practice address fax:** (818) 575-3458
- **Mailing address:** 30699 RUSSELL RANCH ROAD, SUITE 175, WESTLAKE VILLAGE, CA 91362
- **Mailing address phone:** (818) 575-5300
- **Mailing address fax:** (818) 575-3458

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085B0100X | Body Imaging Physician | — | NULL | Yes |
| 2085B0100X | Body Imaging Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/11/2007
- **Last updated:** 06/21/2010