Individual
DR. KENNETH M KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4150 V ST, PSSB 2100, SACRAMENTO, CA 95817-1460
(916) 734-5010
(916) 734-7950
Mailing address
2219 H ST, APT. #2, SACRAMENTO, CA 95816-4045
(312) 208-5090
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A108350
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Enumeration date
08/01/2008
Last updated
02/22/2010
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