Mr. James David Killeen III
Pediatrician
9961 Sierra Ave Kaiser Permanente Fontana - Pediatrics
Fontana
, California 92335-6720
Mr. James David Killeen III
Pediatrician
9961 Sierra Ave Kaiser Permanente Fontana - Pediatrics
Fontana
, California 92335-6720
(877) 514-0903
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About
Features
Specialties
- Pediatrician
Languages spoken
- English
Location
First Address
- Mr. James David Killeen III
- 393 E Walnut St Phr Group Provider Enrollment Unit 3rd Fl
- Pasadena, CA
- Zip : 91188-0001
- Fax : (877) 514-0903
- Phone : (877) 608-0044
Second Address
- Mr. James David Killeen III
- 9961 Sierra Ave Kaiser Permanente Fontana - Pediatrics
- Fontana, CA
- Zip : 92335-6720
- Phone : (909) 427-6960
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208000000X | Pediatrician | A126081 | CA |
National Provider Identifier
| NPI | 1003100579 |
|---|---|
| Provider Name | Mr. James David Killeen III |
| First Address | Pasadena, CA 91188-0001 |
| Second Address | Fontana, CA 92335-6720 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/06/2011 |
| Last Update Date | 03/12/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.