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Contact Information

KEITH M THIBAULT, NP
275 W MACARTHUR
OAKLAND, CA94611-5641
 Phone: 510-752-1000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for KEITH M THIBAULT · (Male)

NPI # 1013078674
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 12/13/2006
Last updated 11/14/2014 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 5122
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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