Kelley, Timothy
Kelley, Timothy is an sole proprietor health care provider with primary practice located at 520 Superior Ave Ste 315 , Newport Beach CA 92663-3667. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery, which is considered as his primary health care specialty. Kelley, Timothy can be contacted via phone (949) 645-3223.Contact Information
Primary practice address
520 Superior Ave Ste 315
Newport Beach CA 92663-3667
Phone: (949) 645-3223
Fax: (949) 645-3222
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery | 207YX0905X | G78999 | California |
Profile Details
| NPI number | 1871528802 |
|---|---|
| LBN Legal business name | Kelley, Timothy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Nov 3rd, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871528802 | NPPES |
| California | MEDICAID | 00G789990 |
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