Individual
THOMAS GARVIN KELSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 MOORPARK AVE, MOORPARK INTERNAL MEDICINE CLINIC, SAN JOSE, CA 95128-2631
(408) 885-4612
Mailing address
751 S BASCOM AVE, SAN JOSE, CA 95128-2604
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G38050
CA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
G38050
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G380500
—
CA
Enumeration date
04/14/2006
Last updated
09/13/2007
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