Organization
JOHN P KELLY MD A PROFESSIONAL MEDICAL CORPORATION
Active
Other names
Orange County Orthopaedic Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN PATRICK KELLY M.D. (PRESIDENT)
(714) 369-9426
Entity
Organization
Contact information
Practice address
2121 MALCOLM AVE, LOS ANGELES, CA 90025-4045
(714) 369-9426
Mailing address
2121 MALCOLM AVE, LOS ANGELES, CA 90025
(714) 369-9426
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A68410
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A68410
MEDICAL LICENSE
CA
01
—
CA297A
MEDICARE GROUP NUMBER
CA
Enumeration date
04/16/2007
Last updated
01/31/2021
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