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Individual
DR. KEITH D SANNEMAN
Active
Individual
DR. KEITH D SANNEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2015
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000E20150
MEDI-CAL
CA
01
—
11774059
CAQH
CA
01
—
1871500371
MEDICARE NPI
CA
01
—
E2015
PTAN
CA
01
—
P00892868
MEDICARE RAILROAD
CA
Enumeration date
08/01/2006
Last updated
03/07/2023
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