Organization
KEEBAN NAM, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEEBAN CALEB NAM MD (PRESIDENT)
(714) 794-9725
Entity
Organization
Contact information
Practice address
23141 MOULTON PKWY STE 213, LAGUNA HILLS, CA 92653-1204
(714) 794-9725
(617) 607-4064
Mailing address
1508 BARTON RD # 325, REDLANDS, CA 92373-1410
(714) 794-9725
(617) 607-4064
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
273R00000X
Psychiatric Hospital Unit
—
—
283Q00000X
Psychiatric Hospital
—
—
Other
Enumeration date
12/04/2019
Last updated
01/17/2023
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