Organization
JON P. KELLY, M.D., A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON PEMBROKE KELLY M.D. (OWNER/PRESIDENT)
(760) 743-0100
Entity
Organization
Contact information
Practice address
255 N ELM ST, SUITE 105, ESCONDIDO, CA 92025-3431
(760) 743-0100
(760) 743-1414
Mailing address
255 N ELM ST, SUITE 105, ESCONDIDO, CA 92025-3431
(760) 743-0100
(760) 743-1414
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A45013
CA
Other
Enumeration date
11/08/2007
Last updated
11/08/2007
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