WILLIAM M. KELLY M.D., INC. (NPI# 1700868338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700868338 |
Entity Type | Organization |
Organization Name | WILLIAM M. KELLY M.D., INC. |
Practice Address |
40700 California Oaks Rd Ste 103 Murrieta CA 92562 |
Mailing Address |
44489 Town Center Way Ste. D Palm Desert CA 92260-2789 |
Practice Telephone | 9518944418 |
Practice Fax Number | 9518944419 |
Mailing Telephone | 7607769777 |
Mailing Fax Number | 7607764999 |
Enumeration Date | 2005-11-18 |
Last Update Date | 2010-01-13 |
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 | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
A34125 | CA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | A341253 | 05 |
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 |
1396816047 | William M. Kelly M.d., Inc. | Radiology | 29798 Haun Rd., Suite 103, Sun City, CA 92586-6541 | 2006-11-13 |
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 |
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 |
40700 CALIFORNIA OAKS RD STE 103 |
City | MURRIETA |
State | CA |
Zip Code | 92562 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326685561 | Stefani Leann Garcia | Counselor | 40700 California Oaks Rd, Ste 202, Murrieta, CA 92562-5789 | 2019-12-06 |
1861034795 | Janet Catherine Davis | Licensed Vocational Nurse | 40700 California Oaks Rd, Murrieta, CA 92562-5795 | 2019-10-11 |
1730656125 | Aimee Lee Irving | Licensed Vocational Nurse | 40700 California Oaks Rd, Murrieta, CA 92562-5795 | 2018-10-24 |
1528541794 | Eric Saidi | Optometrist | 40700 California Oaks Rd, Murrieta, CA 92562-5795 | 2018-09-12 |
1801382296 | Ruby Garcia-miron | Counselor | 40700 California Oaks Rd, Murrieta, CA 92562-5795 | 2018-07-09 |
1417459082 | Danielle Marie Ross | Licensed Vocational Nurse | 40700 California Oaks Rd, Murrieta, CA 92562-5795 | 2018-02-28 |
1649708793 | Douglas Briam Diaz | Counselor | 40700 California Oaks Rd, Murrieta, CA 92562-5795 | 2017-06-01 |
1013445261 | Lachatta Patrece Hunter | Counselor | 40700 California Oaks Rd, Murrieta, CA 92562-5795 | 2017-06-01 |
1366975054 | Jacory Holt | Counselor | 40700 California Oaks Rd, 202, Murrieta, CA 92562-5795 | 2017-04-10 |
1841748605 | Michelle Finlayson | Counselor | 40700 California Oaks Rd, Murrieta, CA 92562-5795 | 2016-09-21 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831709591 | Brittney Schmidt | Behavior Technician | 25109 Hancock Avenue Suite C, Murrieta, CA 92562 | 2020-08-06 |
1518431410 | Heather Marie Halper | Behavioral Analyst | 25190 Handcock Ave, Suite C, Murrieta, CA 92562 | 2019-01-14 |
1164992798 | Tiffany L Lockhart | Counselor | 41780 Mcalby Ct, Murrieta, CA 92562 | 2018-11-27 |
1164992756 | Jessica Gutierrez | Specialist/Technologist | 25102 Jefferson Ave Suite D, Murrieta, CA 92562 | 2018-11-27 |
1972080455 | Tracy M Bronson | Nurse Practitioner | 23811 Washington Ave Ste C110, #203, Murrieta, CA 92562 | 2018-07-26 |
1023500279 | Brittany Marie Ramirez | Counselor | 23824 Matador Way, Murrieta, CA 92562 | 2018-06-04 |
1053800573 | Emily Kathryn Perrott | Physical Therapist | 24630 Washington Ave Ste 200, Murrieta, CA 92562 | 2018-05-10 |
1285151464 | Dexter Villanueva | Physical Therapist | 40845 Engelmann Oak St., Murrieta, CA 92562 | 2017-08-28 |
1407371024 | Elyaszadeh Levi Dental Corporation | Dentist | 40643 California Oaks Rd, Murrieta, CA 92562 | 2017-08-04 |
1023549037 | Andre Cristian De Jesus | Nurse Practitioner | 24640 Jefferson Ave Ste 208, Murrieta, CA 92562 | 2017-03-22 |
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Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
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1639606890 | Premier247 Radiology | Radiology | 38340 Innovation Ct Ste 706, Murrieta, CA 92563-2624 | 2017-05-18 |
1285962068 | Penelope Block | Radiology | 40700 California Oaks Rd Ste 103, Murrieta, CA 92562-5789 | 2009-12-07 |
1467630954 | Tchaiko Parris | Radiology | 25455 Medical Center Dr, Suite 100, Murrieta, CA 92562-5963 | 2008-02-06 |
1790189389 | On-line Radiology Medical Group Inc | Radiology | 28062 Baxter Rd, Murrieta, CA 92563-1401 | 2014-10-10 |
1235280207 | Sussex Radiology | Radiology | 25470 Medical Center Drive, Suite 101, Murrieta, CA 92562 | 2007-01-16 |
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1558960161 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 38209 47th St E Ste D, Palmdale, CA 93552-3113 | 2020-10-23 |
1003415613 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 38925 Trade Center Dr Unit E, Palmdale, CA 93551-3655 | 2020-10-23 |
1083213151 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 44105 15th St W Ste 100, Lancaster, CA 93534-4090 | 2020-10-20 |
1750980967 | Centrelake Medical Group Inc | Radiology | 430 W Stetson Ave, Hemet, CA 92543-7328 | 2020-10-19 |
1538775994 | Richard J. Moran | Radiology | 230 S Main St Ste 101, Orange, CA 92868-3851 | 2020-09-21 |
1417567710 | Family Medical Diagnostics Inc | Radiology | 19231 Victory Blvd Ste 356, Reseda, CA 91335-6308 | 2020-08-03 |
1396365011 | Prodiagnose Inc | Radiology | 7345 Topanga Canyon Blvd # 210, Canoga Park, CA 91303-1244 | 2020-04-22 |
1548892276 | Alvarado Radiology Group Inc, A Professional Corporation | Radiology | 13700 Marina Pointe Dr Unit 430, Marina Del Rey, CA 90292-9277 | 2020-02-11 |
1710518535 | Health Diagnostics of California A Professional Corporation | Radiology | 1690 Barton Rd Ste 107, Redlands, CA 92373-4230 | 2020-01-30 |
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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.