Fenderson, Keith Arlyn
Fenderson, Keith Arlyn is an individual health care provider with primary practice located at 1 Medical Plaza Dr , Roseville CA 95661-3037. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Fenderson, Keith Arlyn can be contacted via phone (916) 781-1000.Contact Information
Primary practice address
1 Medical Plaza Dr
Roseville CA 95661-3037
Phone: (916) 781-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | G42277 | California |
Profile Details
| NPI number | 1902824873 |
|---|---|
| LBN Legal business name | Fenderson, Keith Arlyn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Oct 24th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902824873 | NPPES |
| California | MEDICAID | 00G422770 |
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