KELLY RAE GLENN DPM NPI 1104568419

NPI Information

  • NPI: 1104568419
  • Provider Name: KELLY RAE GLENN, DPM
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Individual
  • Address: 4150 CLEMENT ST
    SAN FRANCISCO, CA
    ZIP 94121
  • Phone: (415) 221-4810

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NPI Details

Kelly Rae Glenn, DPM is a foot and ankle surgery podiatrist in San Francisco, CA. Kelly Rae Glenn, DPM NPI is 1104568419. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4150 CLEMENT ST
SAN FRANCISCO, CA
ZIP 94121-563
Phone: (415) 221-4810

The enumeration date for this NPI number is 4/8/2022 and was last updated on 4/8/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213ES0103XPodiatristFoot & Ankle SurgeryUNKNOWNCALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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