Keith L Agre, MD, Medical Corporation
Clinic/Center, Medical Specialty in Los Angeles, CA. Organization (NPI-2).
Details
- NPI
- 1760664411
- Entity type
- Organization (NPI-2)
- Legal business name
- Keith L Agre, MD, Medical Corporation
- Organization subpart
- No
- Enumeration date
- Dec 4, 2007
- Last updated
- Dec 4, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM2500X | Clinic/Center, Medical Specialty | C24838 | CA | Yes |
Practice location
1125 S Beverly DrSuite 110
Los Angeles, CA 90035-1148
Phone 310-276-2033 · Fax 310-858-3857
Mailing address
1125 S Beverly DrSuite 110
Los Angeles, CA 90035-1148
Phone 310-276-2033 · Fax 310-858-3857
Authorized official
Keith L Agre
President
3102762033
Is something wrong?
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