DR. KELLY M. KEANE (NPI# 1326480476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326480476 |
| Entity Type | Individual |
| Full Name | DR. KELLY M. KEANE |
| Credential | O.D. |
| Practice Address |
5252 Balboa Arms Dr Unit 108 San Diego CA 92117-4953 |
| Mailing Address |
4203 Genesee Ave Suite 103 Pmb 436 San Diego CA 92117-4953 |
| Practice Telephone | (973) 557-5521 |
| Mailing Telephone | 9735575521 |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2020-06-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 15197 | CA | Eye and Vision Services Providers |
| N | 152W00000X | Optometrist | 046010706 | IL | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386076065 | Kelly Catherine Keane | Social Worker | 825 Green Bay Rd, Suite 200, Wilmette, IL 60091-2597 | 2013-08-05 |
| Street Address |
5252 BALBOA ARMS DR UNIT 108 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92117-4953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154956050 | Enbara Corporation | Dentist | 5189 Clairmont Mesa Blvd, San Diego, CA 92117 | 2020-03-11 |
| 1568956050 | Lourdes C Villagran | Case Manager/Care Coordinator | 4474 Charger Blvd, San Diego, CA 92117 | 2018-06-18 |
| 1750893509 | Dzendzel Family Chiropractic | Chiropractor | 3650 Clairemont Drive, Ste 2, San Diego, CA 92117 | 2017-11-02 |
| 1205355401 | Alan Ford | Counselor | 4150 Ute Dr., San Diego, CA 92117 | 2017-09-19 |
| 1780101238 | Allison Dawn Heeney | Occupational Therapist | 3386 Hopi Place, San Diego, CA 92117 | 2017-08-25 |
| 1275074379 | Rachel Gabrielle Packer | Counselor | 5252 Balboa Ave Ste 801, San Diego, CA 92117 | 2017-03-09 |
| 1316482995 | Lisa Graff-marsh, Inc. | Social Worker | 4985 Park Rim Dr., San Diego, CA 92117 | 2017-01-05 |
| 1417408949 | Markos and Markos 1 Inc | Private Vehicle | 4495 Clairemont Mesa Blvd, San Diego, CA 92117 | 2016-10-19 |
| 1801341813 | Huynh and Habashi Dental Corporation | Dentist | 2995 Clairemont Dr, Suite A, San Diego, CA 92117 | 2016-08-19 |
| 1184076077 | Tammy Monck | Optometrist | 3952 Clairemont Mesa Blvd Ste I, San Diego, CA 92117 | 2016-07-05 |
| Find all providers in zip 92117 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720699432 | Emily Thai | Optometrist | 10994 W Ocean Air Dr Apt 286, San Diego, CA 92130-4635 | 2020-08-14 |
| 1841800018 | Luminoptix Optometry | Optometrist | 655 Saturn Blvd Ste H, San Diego, CA 92154-4734 | 2020-08-03 |
| 1427673680 | Courtney Lynn Cape | Optometrist | 4353 La Jolla Village Dr Ste H-20, San Diego, CA 92122-1242 | 2020-06-13 |
| 1073137691 | Charles Tu | Optometrist | 2150 Pacific Beach Dr Apt 234, San Diego, CA 92109-5639 | 2020-05-29 |
| 1538796578 | Wilson Phu | Optometrist | 3345 Rosecrans St Ste B, San Diego, CA 92110-4225 | 2020-03-26 |
| 1346874971 | Florena Culas | Optometrist | 7477 Goode St, San Diego, CA 92139-3931 | 2020-02-22 |
| 1235786633 | Courtney Hongo | Optometrist | San Diego Va 3350 La Jolla Village Dr #1125, San Diego, CA 92161-0001 | 2019-08-20 |
| 1467012740 | Luis G. Perez-rivera Od Optometric Corporation | Optometrist | 11134 Rancho Carmel Dr Ste 102, San Diego, CA 92128-4671 | 2019-06-18 |
| 1063972438 | Fabian Luna Od, Inc | Optometrist | 9855 Erma Rd Ste 130, San Diego, CA 92131-1092 | 2019-03-22 |
| 1790249563 | Imperial Beach Optometric Corporation | Optometrist | 1555 Palm Ave Ste A2, San Diego, CA 92154-1012 | 2019-01-25 |
| Find all providers in SAN DIEGO | ||||
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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.