Kelly, Thomas J

Kelly, Thomas J is an individual health care provider with primary practice located at 11234 Anderson St Ste B623 , Loma Linda CA 92354-2804. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Kelly, Thomas J can be contacted via phone (909) 558-4000.

Contact Information

Primary practice address
11234 Anderson St Ste B623 Loma Linda CA 92354-2804
Phone: (909) 558-4000
Fax: (909) 558-3905
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MA53386 New Jersey
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G073741 California

Profile Details

NPI number 1760421432
LBN Legal business name Kelly, Thomas J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Aug 28th, 2017 - about 7 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 1760421432 NPPES
California Other 10540392 IHG/HEALTHSMART
California MEDICAID 5519004 IHG/HEALTHSMART
California MEDICAID 1760421432 IHG/HEALTHSMART
California Other P01603268 IHG/HEALTHSMART

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