Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | G60630 | CA |
NPI | 1336203496 |
---|---|
Provider Name | Dr. Thomas F Kelly |
First Address | San Diego, CA 92103-8433 |
Second Address | San Diego, CA 92103-8433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 08/07/2007 |