Dewitt, Kelly
Dewitt, Kelly is an individual health care provider with primary practice located at 5555 Grossmont Center Dr , La Mesa CA 91942-3019. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Radiation Oncology. Allopathic & Osteopathic Physicians / Radiation Oncology is her primary health care specialty. Dewitt, Kelly can be contacted via phone (619) 644-4500.Contact Information
Primary practice address
5555 Grossmont Center Dr
La Mesa CA 91942-3019
Phone: (619) 644-4500
Fax: (619) 644-4547
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | A74873 | California |
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | A74873 | California |
Profile Details
| NPI number | 1184668741 |
|---|---|
| LBN Legal business name | Dewitt, Kelly |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Sep 14th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184668741 | NPPES |
| California | MEDICAID | 00A748730 | |
| California | Other | A74873 |
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