Provider Demographics
NPI:1598980880
Name:KELLER, ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:KELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:950 CASS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4546
Mailing Address - Country:US
Mailing Address - Phone:831-373-1100
Mailing Address - Fax:831-373-1630
Practice Address - Street 1:950 CASS ST
Practice Address - Street 2:SUITE B
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4546
Practice Address - Country:US
Practice Address - Phone:831-373-1100
Practice Address - Fax:831-373-1630
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG29481207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44050Medicare UPIN