Individual
MR. JAMES DAVID KILLEEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9961 SIERRA AVE, KAISER PERMANENTE FONTANA - PEDIATRICS, FONTANA, CA 92335-6720
(909) 427-6960
Mailing address
393 E WALNUT ST, PHR GROUP PROVIDER ENROLLMENT UNIT 3RD FL, PASADENA, CA 91188-0001
(877) 608-0044
(877) 514-0903
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A126081
CA
Other
Enumeration date
06/02/2011
Last updated
12/03/2021
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