Individual
JONATHAN M KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
661 WOODLAND DR, SIERRA MADRE, CA 91024-1445
(626) 355-1984
Mailing address
661 WOODLAND DR, SIERRA MADRE, CA 91024-1445
(626) 355-1984
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G26177
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G261770
—
CA
Enumeration date
03/27/2007
Last updated
01/07/2013
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