Provider Demographics
NPI:1225872591
Name:PAGANO, KEITH FRANKILIN (DC)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:FRANKILIN
Last Name:PAGANO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 S LIME ST APT A
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-2891
Mailing Address - Country:US
Mailing Address - Phone:805-824-2560
Mailing Address - Fax:805-824-2560
Practice Address - Street 1:123 S LIME ST APT A
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2891
Practice Address - Country:US
Practice Address - Phone:805-824-2560
Practice Address - Fax:805-824-2560
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36999111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor