Individual
DR. KEITH D SANNEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
520 N ORCHARD DR, BURBANK, CA 91506-1951
(818) 843-3600
(818) 843-0527
Mailing address
520 N ORCHARD DR, BURBANK, CA 91506-1951
(818) 843-3600
(818) 843-0527
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2015
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000E20150
MEDI-CAL
CA
01
—
11774059
CAQH
CA
01
—
1871500371
MEDICARE NPI
CA
01
—
E2015
PTAN
CA
01
—
P00892868
MEDICARE RAILROAD
CA
Enumeration date
08/01/2006
Last updated
03/07/2023
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