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Organization
KELLY AHMED M.D., INC.
Active
Organization
KELLY AHMED M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY J AHMED M.D. (OWNER)
(760) 955-7095
Entity
Organization
Contact information
Practice address
14285 AMARGOSA RD, VICTORVILLE, CA 92392-9707
(760) 955-7095
(760) 951-1076
Mailing address
14285 AMARGOSA RD, VICTORVILLE, CA 92392-9707
(760) 955-7095
(760) 951-1076
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A51407
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A51407
MEDICAL LICEANSE
CA
Enumeration date
10/16/2015
Last updated
10/16/2015
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