WILLIAM M. KELLY M.D., INC. (NPI# 1396816047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396816047 |
| Entity Type | Organization |
| Organization Name | WILLIAM M. KELLY M.D., INC. |
| Other Organization Name | HEALTH SCAN IMAGING |
| Practice Address |
29798 Haun Rd. Suite 103 Sun City CA 92586-6541 |
| Mailing Address |
44489 Town Center Way Ste. D Palm Desert CA 92260-2789 |
| Practice Telephone | 9512446700 |
| Practice Fax Number | 9512446788 |
| Mailing Telephone | 7607769777 |
| Mailing Fax Number | 7607764999 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2010-01-12 |
| Authorized Official Name | MS. MELONIE STORER (CREDENTIALING ADMINISTRATOR) |
| Authorized Official Telephone | 9513022223 |
| Is Organization Subpart | Y |
| Parent Organization Name | WILLIAM M. KELLY M.D., INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085D0003X |
Radiology Specialization: Diagnostic Neuroimaging |
Allopathic & Osteopathic Physicians | ||
| Y | 2471M1202X |
Radiologic Technologist Specialization: Magnetic Resonance Imaging |
A34125 | CA | Technologists, Technicians & Other Technical Service Providers |
| Other Name | Type Code |
|---|---|
| HEALTH SCAN IMAGING | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306078225 | William M. Kelly M.d., Inc. | Radiology | 72980 Fred Waring Dr, Suite A, Palm Desert, CA 92260-2898 | 2009-08-11 |
| 1891969960 | William M. Kelly M.d., Inc. | Radiology | 31565 Rancho Puebla Rd, Suite 101, Temecula, CA 92592-4839 | 2008-04-18 |
| 1235203316 | William M. Kelly M.d., Inc. | Radiology | 8710 Monroe Court, Suite 100, Rancho Cucamonga, CA 91730-4883 | 2006-11-20 |
| 1922172550 | William M. Kelly M.d., Inc. | Radiology | 1080 N. Indian Canyon Dr., Suite 104, Palm Springs, CA 92262-4869 | 2006-11-17 |
| 1922082767 | William M. Kelly M.d., Inc. | Radiology | 72980 Fred Waring Dr., Ste. A, Palm Desert, CA 92260-9339 | 2005-12-05 |
| 1295718161 | William M. Kelly M.d., Inc. | Radiology | 11360 Mountain View Ave, Suite C, Loma Linda, CA 92354-3861 | 2005-11-23 |
| 1700868338 | William M. Kelly M.d., Inc. | Radiology | 40700 California Oaks Rd, Ste 103, Murrieta, CA 92562 | 2005-11-18 |
| 1437149267 | William M. Kelly M.d., Inc. | Radiology | 74000 Country Club Dr, Suite E 1, Palm Desert, CA 92260-2789 | 2005-10-24 |
| 1497069660 | William M. Kelly M.d., Inc. | Radiology | 425 Diamond Dr, Suite 103, Lake Elsinore, CA 92530-4495 | 2010-07-30 |
| Street Address |
29798 HAUN RD. SUITE 103 |
| City | SUN CITY |
| State | CA |
| Zip Code | 92586-6541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053586800 | Binoy Govindbhai Patel | Physical Therapist | 29798 Haun Rd Ste 201, Menifee, CA 92586 | 2008-04-23 |
| 1164552667 | Diana Suzanne Koenen | Marriage & Family Therapist | Sun Plaza Business Center, 27851 Bradley Rd, Suite 103, Menifee, CA 92586 | 2007-03-06 |
| 1972654804 | Mike Johnson | Specialist | 26916 Cherry Hills Boulevard, Sun City, CA 92586 | 2007-01-16 |
| 1932256849 | Mandana Mirshahzadeh | Nurse Practitioner | 26926 Cherry Hills Blvd Ste B, Menifee, CA 92586 | 2007-01-04 |
| 1184709248 | Technomed Homecare Inc | Durable Medical Equipment & Medical Supplies | 27188 Sun City Blvd, Sun City, CA 92586 | 2006-10-26 |
| 1922193754 | Minh Pham | Dentist | 29950 Haun Rd, Ste 302, Sun City, CA 92586 | 2006-10-04 |
| 1598739203 | Kevin Khuong Nguyen | Family Medicine | 29798 Haun Road, Suite 203, Menifee, CA 92586 | 2006-02-17 |
| 1831199728 | Duane Ray Darnell | Internal Medicine | 27994 Bradley Rd, Ste F, Sun City, CA 92586 | 2005-07-21 |
| 1417445040 | Blair N Kluth | Behavioral Analyst | 27070 Sun City Blvd, Menifee, CA 92586 | 2018-04-30 |
| 1043723869 | New Hope Rx Pharmacy, Inc | Pharmacy | 29798 Haun Rd Ste 100, Menifee, CA 92586 | 2017-11-15 |
| Find all providers in zip 92586 | ||||
| Taxonomy Code | 2471M1202X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Magnetic Resonance Imaging |
| Definition to come... |
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| 1629292297 | Valley Radiologist Medical Associates | Radiologic Technologist | 35 Baywood Ave # 2, San Mateo, CA 94402-1516 | 2007-04-12 |
| 1023189560 | Advanced Radiology Healthcare, LLC | Radiologic Technologist | 3885 Cochran St Ste J, Pmb 347, Simi Valley, CA 93063-2367 | 2006-11-13 |
| 1780609644 | Open Advantage Mri IIi, Inc | Radiologic Technologist | 10 Pointe Dr, #110, Brea, CA 92821-3690 | 2006-07-13 |
| 1346265113 | Open Advantage Mri V | Radiologic Technologist | 3115 W March Ln, Suite 110, Stockton, CA 95219-2372 | 2006-07-13 |
| 1336164284 | Open Advantage Mri II | Radiologic Technologist | 600 N Tustin Ave, Suite 100, Santa Ana, CA 92705-3736 | 2006-07-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.