Individual
DR. TIMOTHY KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 SUPERIOR AVE STE 315, NEWPORT BEACH, CA 92663-3667
(949) 645-3223
(949) 645-3222
Mailing address
PO BOX 2975, SUISUN CITY, CA 94585-5975
(657) 241-3600
(657) 241-7708
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
G78999
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G789990
—
CA
Enumeration date
07/11/2006
Last updated
11/03/2023
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