DR. KEVIN M. KELLY MEDICAL DOCTOR NPI 1942299912

NPI Information

NPI: 1942299912
Provider Name: DR. KEVIN M. KELLY, MEDICAL DOCTOR
Classification: Radiology - 2085B0100X
Entity Type: Individual

Specialization: Body Imaging

Address:
50 ALESSANDRO PL
SUITE A30 & A40
PASADENA, CA
ZIP 91105
Phone: (626) 793-6141
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DR. Kevin M. Kelly, MEDICAL DOCTOR is a body imaging radiology in Pasadena, CA. The provider is a Radiology doctor of Osteopathy that specializes in Body Imaging. DR. Kevin M. Kelly, MEDICAL DOCTOR NPI is 1942299912. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

50 ALESSANDRO PL
SUITE A30 & A40
PASADENA, CA
ZIP 91105-149
Phone: (626) 793-6141
Fax: (626) 796-0172

The enumeration date for this NPI number is 10/20/2005 and was last updated on 7/8/2007.

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
1	2085B0100X	Radiology	Body Imaging	G24330	CALIFORNIA	Yes
2	2085R0202X	Radiology	Diagnostic Radiology	G24330	CALIFORNIA	X
3	2085N0904X	Radiology	Nuclear Radiology	G24330	CALIFORNIA	X
4	2085R0204X	Radiology	Vascular & Interventional Radiology	G24330	CALIFORNIA	X
5	2085U0001X	Radiology	Diagnostic Ultrasound	G24330	CALIFORNIA	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	00G243300	MEDICAID	CALIFORNIA
2	A42231	MEDICARE UPIN	CALIFORNIA
3	WG24330A	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA

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: 4/28/2024

NPI Synchronization or Removal

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