Individual
CHARLES E. KELLER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1010 W. LAVETA AVENUE, SUITE 175, ORANGE, CA 92868-4304
(714) 633-5696
(714) 633-5490
Mailing address
1010 W. LAVETA AVENUE, SUITE 175, ORANGE, CA 92868-4304
(714) 633-5696
(714) 633-5490
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
CA
Other
Enumeration date
04/11/2006
Last updated
07/01/2010
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