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Individual

LEROY WAYNE KEISER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3555 ROUND BARN CIR STE 100, SANTA ROSA, CA 95403-1757
(707) 528-1050
(707) 525-3874
Mailing address
3555 ROUND BARN CIR, SANTA ROSA, CA 95403-1757

Taxonomy

Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
G28436
CA
207RH0003X
Hematology & Oncology Physician
Primary
G28436
CA
207RX0202X
Medical Oncology Physician
G28436
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G284360
CA
Enumeration date
10/13/2006
Last updated
11/03/2021
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