Individual
DR. KEVIN M. KELLY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MEDICAL DOCTOR
Contact information
Practice address
50 ALESSANDRO PL, SUITE A30 & A40, PASADENA, CA 91105-3149
(626) 793-6141
(626) 796-0172
Mailing address
223 N 1ST AVE, ARCADIA, CA 91006-7089
(626) 821-1411
(626) 821-0406
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
G24330
CA
2085N0904X
Nuclear Radiology Physician
G24330
CA
2085R0202X
Diagnostic Radiology Physician
G24330
CA
2085R0204X
Vascular & Interventional Radiology Physician
G24330
CA
2085U0001X
Diagnostic Ultrasound Physician
Primary
G24330
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G243300
—
CA
Enumeration date
10/20/2005
Last updated
09/11/2025
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