Individual
DANNY LEE KEILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4033 3RD AVE, SUITE 400, SAN DIEGO, CA 92103-2117
(619) 299-0670
(858) 429-7929
Mailing address
PO BOX 33865, SAN DIEGO, CA 92163-3865
(858) 888-7700
(858) 888-7721
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
C32092
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C320920
—
CA
01
—
GR0043510
MEDICAID GROUP PROVIDER
CA
01
—
WC32092G
PPIN
CA
Enumeration date
08/23/2006
Last updated
03/18/2020
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