Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | A89531 | CA |
Y | 208200000X | Surgeon | A89531 | CA |
Y | 208600000X | Surgeon | A89531 | CA |
NPI | 1013043314 |
---|---|
Provider Name | Dr. Leah Morton Kelley |
First Address | Greenbrae, CA 94904-2011 |
Second Address | Greenbrae, CA 94904-2011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 24/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RES000 | (02) | CA |