Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | A99273 | CA |
NPI | 1013105725 |
---|---|
Provider Name | Dr. Nate Eugene Kelly |
First Address | Los Altos, CA 94022-1408 |
Second Address | Mountain View, CA 94040-2833 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2007 |
Last Update Date | 11/01/2022 |