Organization
WILLIAM M. KELLY M.D., INC.
Active
Parent organization
WILLIAM M. KELLY M.D., INC
Other names
Truly Open MRI
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLIAM M. KELLY M.D., INC
Authorized official
MS. MELONIE STORER (CREDENTIALING ADMINISTRATOR)
(951) 302-2223
Entity
Organization
Contact information
Practice address
72980 FRED WARING DR., STE. A, PALM DESERT, CA 92260-9339
(760) 776-8001
(760) 674-8282
Mailing address
44489 TOWN CENTER WAY, STE. D, PALM DESERT, CA 92260-2789
(760) 776-9777
(760) 776-4999
Taxonomy
Speciality
Code
Description
License number
State
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
Primary
A34125
CA
2085N0700X
Neuroradiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00341250
—
CA
Enumeration date
12/05/2005
Last updated
01/12/2010
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