Individual
NOAH E KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 EUREKA RD, ROSEVILLE, CA 95661-3027
(916) 784-4000
(877) 738-4262
Mailing address
1800 HARRISON ST FL 7, OAKLAND, CA 94612-3466
(510) 625-2856
(877) 738-4262
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2007-01217
NC
2086S0120X
Pediatric Surgery Physician
Primary
A117557
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5907236
—
NC
05
—
N01218
—
SC
Enumeration date
05/29/2007
Last updated
03/30/2022
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