KEEBAN NAM, M.D., INC. (NPI# 1295372621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295372621 |
| Entity Type | Organization |
| Organization Name | KEEBAN NAM, M.D., INC. |
| Practice Address |
31872 Coast Hwy Laguna Beach CA 92651-6773 |
| Mailing Address |
3943 Irvine Blvd #76 Irvine CA 92602-2400 |
| Practice Telephone | 7147949725 |
| Practice Fax Number | 6176074064 |
| Mailing Telephone | 7147949725 |
| Mailing Fax Number | 6176074064 |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2019-12-20 |
| Authorized Official Name | DR. KEEBAN CALEB NAM (PRESIDENT) |
| Authorized Official Telephone | 7147949725 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| N | 273R00000X | Psychiatric Unit | Hospital Units | ||
| N | 283Q00000X | Psychiatric Hospital | Hospitals | ||
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
31872 COAST HWY |
| City | LAGUNA BEACH |
| State | CA |
| Zip Code | 92651-6773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548258239 | Amir H Ronaghi | Radiology | 31872 Coast Hwy, Laguna Beach, CA 92651-6773 | 2005-10-07 |
| 1447809629 | Jemma Coster | Nurse Practitioner | 31872 Coast Hwy, Laguna Beach, CA 92651-6773 | 2019-09-10 |
| 1902364995 | Krista Marie Stone | Registered Nurse | 31872 Coast Hwy, Laguna Beach, CA 92651-6773 | 2019-03-08 |
| 1487121984 | Brian Choi M.d. Mba | Clinic/Center | 31872 Coast Hwy, Laguna Beach, CA 92651-6773 | 2018-11-01 |
| 1366952152 | Shabnam Esmailzadeh K | Acupuncturist | 31872 Coast Hwy, Laguna Beach, CA 92651-6773 | 2017-10-05 |
| 1316462732 | Gregory Scott Ware | Pharmacist | 31872 Coast Hwy, Laguna Beach, CA 92651-6773 | 2017-08-07 |
| 1245767441 | Orange County Psych Specialists | Psychiatry & Neurology | 31872 Coast Hwy, Laguna Beach, CA 92651-6773 | 2017-05-18 |
| 1861866741 | Jonathan E Shaywitz Md Inc | Psychiatry & Neurology | 31872 Coast Hwy, Laguna Beach, CA 92651-6773 | 2015-11-16 |
| 1194162347 | Olivia Granados | Registered Nurse | 31872 Coast Hwy, Laguna Beach, CA 92651-6773 | 2013-05-29 |
| 1619293925 | Trisha Kathleen Sutch | Nurse Practitioner | 31872 Coast Hwy, Laguna Beach, CA 92651-6773 | 2010-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043856073 | Ocean View Neuropsychiatry | Psychiatry & Neurology | 31862 Coast Highway Unit 302, Laguna Beach, CA 92651 | 2019-11-25 |
| 1871154526 | Jinyi Bae | Psychiatry & Neurology | 31872 Coast Highway, Behavioral Health Unit, Laguna Beach, CA 92651 | 2019-06-24 |
| 1790348209 | Karen Veseth | Pharmacist | 30842 South Pacific Coast Highway, Laguna Beach, CA 92651 | 2019-04-19 |
| 1629536602 | Briana Kim | Pharmacist | 30842 S Pacific Coast Highway, Laguna Beach, CA 92651 | 2019-03-08 |
| 1295246288 | Priscilla Newton | Marriage & Family Therapist | 1427 Catalina, Laguna Beach, CA 92651 | 2017-10-17 |
| 1659723609 | Kassie Claughton | Social Worker | 1986 S Coast Hwy, Suite 1600, Laguna Beach, CA 92651 | 2016-07-01 |
| 1285029629 | Kathleen Susan Wenger | Counselor | 1550 South Pacific Coast Highway, #205, Laguna Beach, CA 92651 | 2015-04-02 |
| 1316350044 | Marcus D Yetter | Podiatrist | 31852 Coast Hwy Ste 105, Laguna Beach, CA 92651 | 2014-06-10 |
| 1891105854 | Connie Lee Bird | Social Worker | 332 Forest Ave #21, Laguna Beach, CA 92651 | 2014-04-30 |
| 1578989745 | Ana Maria Guerrero | Acupuncturist | 1100 South Coast Highway # 215, Laguna Beach, CA 92651 | 2014-03-12 |
| Find all providers in zip 92651 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487121984 | Brian Choi M.d. Mba | Clinic/Center | 31872 Coast Hwy, Laguna Beach, CA 92651-6773 | 2018-11-01 |
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| Find all providers with the same taxonomy | ||||
| City | LAGUNA BEACH |
| Zip Code | 92651 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.