WILLIAM M. KELLY M.D., INC.


Address: 8710 Monroe Court, Suite 100, Rancho Cucamonga, CA 91730-4883
Phone: 9095816480

WILLIAM M. KELLY M.D., INC. (NPI# 1235203316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235203316
Entity Type Organization
Organization Name WILLIAM M. KELLY M.D., INC.
Other Organization Name HEALTH SCAN IMAGING
Practice Address 8710 Monroe Court
Suite 100
Rancho Cucamonga
CA 91730-4883
Mailing Address 44489 Town Center Way
Ste. D
Palm Desert
CA 92260-2789
Practice Telephone 9095816480
Practice Fax Number 9095816481
Mailing Telephone 7607769777
Mailing Fax Number 7607764999
Enumeration Date 2006-11-20
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.

Taxonomy

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 Provider/Organization Names

Other Name Type Code
HEALTH SCAN IMAGING Doing Business As Name - Organization

Other Provider IDs and Locations

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
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
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

Office Location

Street Address 8710 MONROE COURT
SUITE 100
City RANCHO CUCAMONGA
State CA
Zip Code 91730-4883

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NPI Name Taxonomy Address Enumeration
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1497300180 Laura Estela Le Behavior Technician 8350 Archilbald Ave Ste 110, Rancho Cucamonga, CA 91730 2019-08-08
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1568023745 Mariah Wright Behavior Technician 10532 Arcacia St, B-11, Rancho Cucamonga, CA 91730 2019-06-27
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1700361326 Brittany Rhone Behavioral Analyst 933 Baseline Rd, Rancho Cucamonga, CA 91730 2018-09-28
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Taxonomy Information

Taxonomy Code 2471M1202X
Grouping Technologists, Technicians & Other Technical Service Providers
Classification Radiologic Technologist
Specialization Magnetic Resonance Imaging

Taxonomy Definition

Definition to come...

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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
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Competitor

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City RANCHO CUCAMONGA
Zip Code 91730

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Dataset Information

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.

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