Individual
KELLAN KALBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1941 JOHNSON AVE STE 101, SAN LUIS OBISPO, CA 93401-4154
(805) 782-8844
(805) 782-8859
Mailing address
1941 JOHNSON AVE STE 101, SAN LUIS OBISPO, CA 93401-4154
(805) 782-8844
(805) 782-8859
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
60114
CA
Other
Enumeration date
07/09/2020
Last updated
04/12/2022
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