Kelaita, Dean Matthew

Kelaita, Dean Matthew is an individual health care provider with primary practice located at 702 Mountain Ranch Rd. , San Andreas CA 95249. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kelaita, Dean Matthew can be contacted via phone (209) 754-0870.

Contact Information

Primary practice address
702 Mountain Ranch Rd. San Andreas CA 95249
Phone: (209) 754-0870
Fax: (209) 754-0878
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G80069 California

Profile Details

NPI number 1750310496
LBN Legal business name Kelaita, Dean Matthew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Mar 7th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750310496 NPPES
California MEDICAID 00G800690

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