Individual
KEITH PAYNE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
34800 BOB WILSON DR, NMCSD, ATTN MEDICAL STAFF SERVICES, SAN DIEGO, CA 92134-1098
(619) 532-6460
Mailing address
34800 BOB WILSON DR, NMCSD, ATTN MEDICAL STAFF SERVICES, SAN DIEGO, CA 92134-1098
(619) 532-6460
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
14225
CA
Other
Enumeration date
02/23/2006
Last updated
07/08/2007
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