BRIAN KELLERT (NPI# 1215224761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215224761 |
| Entity Type | Individual |
| Full Name | BRIAN KELLERT |
| Credential | D.O. |
| Practice Address |
110 Tampico Drive Suite 100 Walnut Creek CA 94598-1267 |
| Mailing Address |
110 Tampico Drive Suite 100 Walnut Creek CA 94598-2961 |
| Practice Telephone | 9258919033 |
| Practice Fax Number | 9258919066 |
| Mailing Telephone | 9258919033 |
| Mailing Fax Number | 9258919066 |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 20A15787 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICAL LICENSE | 20A15787 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 395 W 12th Ave, Columbus, OH 432101267 | 6142938515 | 6142935877 |
| Street Address |
110 TAMPICO DRIVE SUITE 100 |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94598-1267 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639716608 | Tasnim Diaf Moulton | Counselor | 2730 Shadelands Drive, Walnut Creek, CA 94598 | 2019-12-09 |
| 1790255370 | Harmony Grace Davis | Behavior Technician | 2730 Shadelands Drive Bldg 10, Walnut Creek, CA 94598 | 2018-11-27 |
| 1922583772 | Melissa Anne Mcgovern | Behavioral Analyst | 2370 Shadelands Drive, Bldg 10, Walnut Creek, CA 94598 | 2018-09-27 |
| 1184108367 | Brett Heflin Woodrufff | Behavior Technician | 2730 Shandeland Dr. Building 10, Walnut Creek, CA 94598 | 2018-09-24 |
| 1710411640 | Mandy Wei | Pharmacist | 2880 Shadeland Dr, Suite 201, Walnut Creek, CA 94598 | 2017-04-18 |
| 1437683497 | Hayley Miller | Student in an Organized Health Care Education/Training Program | 2204 Lomond Lane, Walnut Creek, CA 94598 | 2017-04-17 |
| 1043601594 | Marlene Perez Riedel | Nurse Practitioner | 450 North Wiget Lane, Walnut Creek, CA 94598 | 2015-02-05 |
| 1922418904 | Dante Michael Sorrentino | Ophthalmology | Kaiser Permanente Park Shadelands Medical Offices, 320 Lennon Lane, Walnut Creek, CA 94598 | 2014-04-30 |
| 1194156505 | Robert Harrison Hubbell | Obstetrics & Gynecology | 838 Stonehaven Dr, Walnut Creek, CA 94598 | 2013-12-11 |
| 1174954192 | Paul Mead | Orthopaedic Surgery | 2405 Shadelands Dr Ste 300, Walnut Creek, CA 94598 | 2013-12-01 |
| Find all providers in zip 94598 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497257950 | Baychildren's Physicians | Obstetrics & Gynecology | 2970 Camino Diablo Ste 200, Walnut Creek, CA 94597-4001 | 2018-03-01 |
| 1790173292 | My-linh Thi Nguyen | Obstetrics & Gynecology | 100 N Wiget Ln Ste 290, Walnut Creek, CA 94598-5901 | 2015-01-06 |
| 1104245711 | Lillian Darlene Lanka | Obstetrics & Gynecology | 634 Shadowhawk Way, Walnut Creek, CA 94595 | 2014-04-10 |
| 1376969774 | Richard Allen Kaplan | Obstetrics & Gynecology | 1808 Castle Gate Road, Walnut Creek, CA 94595 | 2014-03-10 |
| 1194156505 | Robert Harrison Hubbell | Obstetrics & Gynecology | 838 Stonehaven Dr, Walnut Creek, CA 94598 | 2013-12-11 |
| 1538488226 | Dr. Louis A.klein | Obstetrics & Gynecology | 112 La Casa Via Ste 130, Walnut Creek, CA 94598-3016 | 2010-05-20 |
| 1063627362 | Madhavi Durga Vemulapalli | Obstetrics & Gynecology | 112 La Casa Via Ste 300, Walnut Creek, CA 94598-3059 | 2007-05-11 |
| 1811042807 | Robert W Mayo | Obstetrics & Gynecology | 4225 Arbolado Dr, Walnut Creek, CA 94598-4682 | 2007-01-23 |
| 1063590677 | Mark Allen Patterson | Obstetrics & Gynecology | 2657 Saklan Indian Dr Apt 2, Walnut Creek, CA 94595-3026 | 2006-11-01 |
| 1548362122 | Anh Thuy Do | Obstetrics & Gynecology | 1455 Montego Ste 100, Walnut Creek, CA 94598-2952 | 2006-09-02 |
| Find all providers in WALNUT CREEK | ||||
| City | WALNUT CREEK |
| Zip Code | 94598 |
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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.