Provider Demographics
NPI:1437048386
Name:ROJAS, KEANO REYES
Entity type:Individual
Prefix:
First Name:KEANO
Middle Name:REYES
Last Name:ROJAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 HARBOR VILLAGE DR APT D
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-5224
Mailing Address - Country:US
Mailing Address - Phone:310-684-8277
Mailing Address - Fax:
Practice Address - Street 1:2292 FARADAY AVE
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-7238
Practice Address - Country:US
Practice Address - Phone:562-607-9527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program