Organization
DEAN M KELAITA M D MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN M KELAITA MD (CEO)
(209) 483-4760
Entity
Organization
Contact information
Practice address
900 MOUNTAIN RANCH RD, SAN ANDREAS, CA 95249-9713
(209) 483-4760
Mailing address
PO BOX 30, MOKELUMNE HILL, CA 95245-0030
(209) 483-4760
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/17/2021
Last updated
10/18/2021
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