Individual
KEITH FORREST KORVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3510 UNOCAL PL STE 207, SANTA ROSA, CA 95403-0918
(707) 569-7860
(707) 545-5408
Mailing address
3510 UNOCAL PL STE 207, SANTA ROSA, CA 95403-0918
(707) 569-7860
(707) 545-5408
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G52235
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G52235
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G522350
BLUE SHIELD OF CALIFORNIA
CA
05
—
00G522350
—
CA
Enumeration date
07/14/2005
Last updated
07/15/2021
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