Individual
ELLEN J. KILLEBREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
901 NEVIN AVE, RICHMOND, CA 94801-3143
(510) 307-1708
Mailing address
901 NEVIN AVE, RICHMOND, CA 94801-3143
(510) 307-1708
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G14853
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G148530
—
CA
Enumeration date
04/08/2008
Last updated
04/08/2008
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