Kelley, Richard

Kelley, Richard is an individual health care provider with primary practice located at 1441 Florida Ave , Modesto CA 95350-4404. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Kelley, Richard can be contacted via phone (209) 576-3609.

Contact Information

Primary practice address
1441 Florida Ave Modesto CA 95350-4404
Phone: (209) 576-3609
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP13052 California
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA15710 California

Profile Details

NPI number 1558316786
LBN Legal business name Kelley, Richard
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Jan 3rd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558316786 NPPES
California Other CD069A GROUP PTAN GREATER MODESTO MEDICAL SURGICAL ASSOCIATES

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