Individual
BRIAN KELLERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
110 TAMPICO DRIVE SUITE 100, WALNUT CREEK, CA 94598-1267
(925) 891-9033
(925) 891-9066
Mailing address
110 TAMPICO DRIVE SUITE 100, WALNUT CREEK, CA 94598-2961
(925) 891-9033
(925) 891-9066
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
20A15787
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A15787
MEDICAL LICENSE
CA
Enumeration date
07/06/2011
Last updated
03/17/2018
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