Organization
KEITH L AGRE, MD, MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH L AGRE M.D. (PRESIDENT)
(310) 276-2033
Entity
Organization
Contact information
Practice address
1125 S BEVERLY DR, SUITE 110, LOS ANGELES, CA 90035-1148
(310) 276-2033
(310) 858-3857
Mailing address
1125 S BEVERLY DR, SUITE 110, LOS ANGELES, CA 90035-1148
(310) 276-2033
(310) 858-3857
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
C24838
CA
Other
Enumeration date
12/04/2007
Last updated
12/04/2007
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