Kelly, Kevin M.
Kelly, Kevin M. is an individual health care provider with primary practice located at 50 Alessandro Pl Suite A30 & A40, Pasadena CA 91105-3149. He recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Body Imaging is his primary health care specialty. Kelly, Kevin M. can be contacted via phone (626) 793-6141.Contact Information
Primary practice address
50 Alessandro Pl Suite A30 & A40
Pasadena CA 91105-3149
Phone: (626) 793-6141
Fax: (626) 796-0172
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | G24330 | California |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | G24330 | California |
| Allopathic & Osteopathic Physicians / Nuclear Radiology | 2085N0904X | G24330 | California |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | G24330 | California |
| Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X | G24330 | California |
Profile Details
| NPI number | 1942299912 |
|---|---|
| LBN Legal business name | Kelly, Kevin M. |
| Credentials | MEDICAL DOCTOR |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 20th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1942299912 | NPPES |
| California | MEDICAID | 00G243300 |
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