Kelly, Scott Andrew

Kelly, Scott Andrew is an individual health care provider with primary practice located at 242 Avenida Pelayo Unit A , San Clemente CA 92672-5033. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Kelly, Scott Andrew can be contacted via phone (773) 491-2746.

Contact Information

Primary practice address
242 Avenida Pelayo Unit A San Clemente CA 92672-5033
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Independent Duty Corpsman 1710I1002X

Profile Details

NPI number 1548891526
LBN Legal business name Kelly, Scott Andrew
Credentials SOIDC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 29th, 2020
Last updated Jan 29th, 2020 - about 5 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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