Organization · Type 2 NPI

Keith L Agre, Md, Medical Corporation

Medical Specialty Clinic/Center · Los Angeles, CA

NPI number 1760664411 Active

Practice location

1125 S Beverly Dr, Suite 110
Los Angeles, CA 90035-1148

Call (310) 276-2033 Map

Fax (310) 858-3857

Specialties and licenses

TaxonomyCodeLicense
Medical Specialty Clinic/Center Primary 261QM2500XC24838 (CA)

Medical Specialty Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

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About NPI 1760664411

Keith L Agre, Md, Medical Corporation's National Provider Identifier is 1760664411, issued on Dec 4, 2007. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in Los Angeles, CA. The record was last updated on Dec 4, 2007.