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Individual

DR. KELLEY MARIE KALIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
726 FOURTH STREET, MARYSVILLE, CA 95901-5656
(530) 749-4300
Mailing address
PO BOX 3067, YUBA CITY, CA 95992-3067
(530) 751-4784
(530) 751-4906

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0102203411
VA
207L00000X
Anesthesiology Physician
036128905
IL
207L00000X
Anesthesiology Physician
Primary
20A14277
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1972777225
VA
01
P01106596
RAILROAD MEDICARE PTAN
IL
Enumeration date
04/17/2008
Last updated
01/19/2017
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