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Organization

WILLIAM M. KELLY M.D., INC.

Active
Parent organization
WILLIAM M. KELLY M.D., INC.
Other names
Open MRI of Loma Linda
Organization subpart
Yes

Provider details

NPI number
Legal business name
WILLIAM M. KELLY M.D., INC.
Authorized official
MS. MELONIE STORER (CREDENTIALING ADMINISTRATOR)
(951) 302-2223
Entity
Organization

Contact information

Practice address
11360 MOUNTAIN VIEW AVE, SUITE C, LOMA LINDA, CA 92354-3861
(909) 478-3300
(909) 478-3900
Mailing address
44489 TOWN CENTER WAY, STE. D, PALM DESERT, CA 92260-2789
(760) 776-9777
(760) 776-4999

Taxonomy

Speciality
Code
Description
License number
State
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
Primary
A34125
CA
2085R0202X
Diagnostic Radiology Physician
A34125
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A341251
CA
Enumeration date
11/23/2005
Last updated
01/12/2010
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