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Organization

KELLY MAH, M.D.

Active
Other names
Manteca Obstetrics and Gynecology Medical Group
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY MAH M.D. (PRESIDENT)
(209) 823-7616
Entity
Organization

Contact information

Practice address
421 E CENTER ST, MANTECA, CA 95336-4718
(209) 823-7616
(209) 823-4352
Mailing address
421 E CENTER ST, MANTECA, CA 95336-4718
(209) 823-7616
(209) 823-4352

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G065156
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G065156
MEDICAL LICENSE NUMBER
CA
05
GR0045320
CA
Enumeration date
09/25/2006
Last updated
03/07/2023
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