Provider Demographics
NPI:1336272830
Name:KEYSER, SVETLANA R (MD)
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:R
Last Name:KEYSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10471 FAIRWAY LN
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8042
Mailing Address - Country:US
Mailing Address - Phone:831-372-7575
Mailing Address - Fax:831-372-7575
Practice Address - Street 1:2600 GARDEN RD STE 224
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5359
Practice Address - Country:US
Practice Address - Phone:831-372-7575
Practice Address - Fax:831-372-7575
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41737174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist