Individual
CLIFFORD KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
637 E ALBERTONI ST, #109, CARSON, CA 90746-1539
(213) 820-1511
(310) 626-9754
Mailing address
637 E ALBERTONI ST, #109, CARSON, CA 90746-1539
(213) 820-1511
(310) 626-9754
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
190600AP
CA
Other
Enumeration date
08/18/2009
Last updated
08/18/2009
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