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Organization

CARMEL HEALTHCARE ANESTHESIA MEDICAL PROVIDERS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD J KELLY MD (GROUP PRESIDENT)
(831) 333-4000
Entity
Organization

Contact information

Practice address
2 UPPER RAGSDALE DR, BLDG B, STE B160, MONTEREY, CA 93940-5736
(831) 333-4000
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0105420
CA
01
ZZZ627402
BLUE SHIELD OF CA
CA
01
ZZZ62741Z
BLUE SHIELD OF CA
CA
01
ZZZ62742Z
BLUE SHIELD OF CA
CA
Enumeration date
08/09/2007
Last updated
12/05/2007
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