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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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