Provider Demographics
NPI:1053571729
Name:HARVEY, KEITH
Entity type:Individual
Prefix:MR
First Name:KEITH
Middle Name:
Last Name:HARVEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43360 GADSDEN AVE
Mailing Address - Street 2:135
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-6088
Mailing Address - Country:US
Mailing Address - Phone:661-492-9703
Mailing Address - Fax:
Practice Address - Street 1:43432 DIVISION ST
Practice Address - Street 2:107
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535
Practice Address - Country:US
Practice Address - Phone:661-726-2850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator