Organization
CARMEL HEALTHCARE ANESTHESIA MEDICAL PROVIDERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD J KELLY MD (GROUP PRESIDENT)
(831) 624-5311
Entity
Organization
Contact information
Practice address
23625 HOLMAN HIGHWAY, MONTEREY, CA 93940
(831) 624-5311
Mailing address
484 B WASHINGTON ST, PMB 345, MONTEREY, CA 93940
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0105420
—
CA
01
—
ZZZ62740Z
BLUE SHIELD OF CA
CA
01
—
ZZZ62741Z
BLUE SHIELD OF CA
CA
01
—
ZZZ62742Z
BLUE SHIELD OF CA
CA
Enumeration date
06/28/2007
Last updated
12/05/2007
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