Individual
JENNIFER CAROLINE KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1285 S STATE ST, HEMET, CA 92543-7976
(951) 765-1777
(951) 765-1772
Mailing address
27699 JEFFERSON AVE, SUITE 300, TEMECULA, CA 92590-2661
(951) 252-8588
(951) 252-8589
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G83301
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G833010
MEDI-CAL PROVIDER NUMBER
CA
Enumeration date
09/21/2006
Last updated
05/10/2017
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