Individual
DR. KELLEY CORENNE GILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027
(954) 558-7097
Mailing address
4650 W SUNSET BLVD, MAILSTOP #94, LOS ANGELES, CA 90027
(323) 361-8762
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
143943
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2015
Last updated
03/18/2019
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