Individual
KELLY BALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4074 FALCON ST, SAN DIEGO, CA 92103-1857
(206) 355-5967
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
(858) 249-6748
(619) 543-3183
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95004819
CA
Other
Enumeration date
01/30/2017
Last updated
05/22/2017
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