Kelley, Diane M.

Kelley, Diane M. is an individual health care provider with primary practice located at 975 Sereno Dr , Vallejo CA 94589-2441. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Kelley, Diane M. can be contacted via phone (707) 651-1000.

Contact Information

Primary practice address
975 Sereno Dr Vallejo CA 94589-2441
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X G43839 California

Profile Details

NPI number 1295813012
LBN Legal business name Kelley, Diane M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295813012 NPPES
California MEDICAID 00G438390

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