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Individual

ANTHONY KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
405 W 5TH ST, SANTA ANA, CA 92701-4599
(714) 834-2178
Mailing address
6053 KINGSBRIAR DR, YORBA LINDA, CA 92886-5918
(657) 272-0334

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
550311
CA

Other

Enumeration date
08/18/2021
Last updated
08/18/2021
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