Kyle Kelly is a Military Health Care Provider based in San Diego, CA. Kyle Kelly practices in San Diego, CA. The NPI Number for Kyle Kelly is 1720581820 and holds a License No. (California).
The current practice location address for Kyle Kelly is 34800 Bob Wilson Dr, San Diego, CA and can be reached out via phone at 619-532-6474.
Location: 34800 Bob Wilson Dr, San Diego, CA, 92134-5000
Provider Profile Details
NPI Number
1720581820
Provider Name
Kyle Kelly
Credential
Provider Entity Type
Individual
Gender
Male
Address
34800 Bob Wilson Dr, San Diego, CA, 92134-5000
Phone Number
619-532-6474
Fax Number
Provider Enumeration Date
03/14/2018
Last Update Date
03/10/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| VAD0000 | 01 | MILITARY |
Provider Business Practice Location Address Details
Address
34800 Bob Wilson Dr
City
State
Zip
92134-5000
Phone Number
619-532-6474
Fax Number
Provider Business Mailing Address Details
Address
34800 Bob Wilson Dr
City
State
Zip
92134-5000
Phone Number
619-532-6474
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
License No.
DR.0062789 (Colorado)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Badge
Use the following badge on your website to showcase your NPI number and verified status. In a field with over 8 million healthcare providers in the United States, it is important to establish your identity clearly. Displaying this badge signifies that your information is both accurate and up-to-date.