Provider Demographics
NPI:1952551228
Name:KEA, JON P (M,D)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:P
Last Name:KEA
Suffix:
Gender:M
Credentials:M,D
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8700 BEVERLY BLVD
Mailing Address - Street 2:B-220
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-423-5252
Mailing Address - Fax:310-423-8441
Practice Address - Street 1:8700 BEVERLY BLVD
Practice Address - Street 2:B-220
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-423-5252
Practice Address - Fax:310-423-8441
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2015-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA105566207R00000X, 208M00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist