Individual
CAROLYN JEAN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3350 LA JOLLA VILLAGE DR, MAIL CODE 111H, SAN DIEGO, CA 92161-0002
(858) 552-7528
Mailing address
9500 GILMAN DRIVE, MEDICAL TEACHING FACILITY 180 MAILCODE 0606, LA JOLLA, CA 92093-0606
(858) 534-3701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G75680
CA
207RN0300X
Nephrology Physician
Primary
G75680
CA
Other
Enumeration date
07/28/2006
Last updated
07/16/2007
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