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Organization

WILLIAM M. KELLY M.D., INC.

Active
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Organization

WILLIAM M. KELLY M.D., INC.

Active
Parent organization
WILLIAM M. KELLY M.D., INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
WILLIAM M. KELLY M.D., INC.
Authorized official
MS. MELONIE STORER (CREDENTIALING ADMINISTRATOR)
(951) 302-2223
Entity
Organization

Contact information

Practice address
40700 CALIFORNIA OAKS RD, STE 103, MURRIETA, CA 92562
(951) 894-4418
(951) 894-4419
Mailing address
44489 TOWN CENTER WAY, STE. D, PALM DESERT, CA 92260-2789
(760) 776-9777
(760) 776-4999

Taxonomy

Speciality
Code
Description
License number
State
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
A34125
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A341253
—
CA
Enumeration date
11/18/2005
Last updated
01/13/2010
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