MRS. ROSEMARY TILMON-KELLUM (NPI# 1710047220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710047220 |
Entity Type | Individual |
Full Name | MRS. ROSEMARY TILMON-KELLUM |
Other Name | MRS. ROSEMARY KELLUM |
Credential | PA-C |
Practice Address |
1250 Bellflower Blvd. Student Health Center Long Beach CA 90840 |
Mailing Address |
1250 Bellflower Blvd Student Health Center Long Beach CA 90840 |
Practice Telephone | 5629854771 |
Practice Fax Number | 5629851644 |
Mailing Telephone | 5629854771 |
Mailing Fax Number | 5629851644 |
Enumeration Date | 2006-12-12 |
Last Update Date | 2018-12-26 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
13327 | CA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1250 BELLFLOWER BLVD. STUDENT HEALTH CENTER |
City | LONG BEACH |
State | CA |
Zip Code | 90840 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881972719 | Kathleen Elizabeth Hollwig | Marriage & Family Therapist | 101 Mail Street, Suite F, Seal Beach, CA 90840 | 2011-07-26 |
1538377056 | James Edward Koval | Marriage & Family Therapist | Family and Consumer Sciences, Csulb, Long Beach, CA 90840 | 2007-05-18 |
1558993147 | Steven Ryan Tran | Physical Therapist | 1250 Bellflower Blvd, Kin-105, Long Beach, CA 90840 | 2020-02-11 |
1790286482 | Justin Caovan | Student in an Organized Health Care Education/Training Program | 1250 Bellflower Blvd, Long Beach, CA 90840 | 2018-02-27 |
1295235927 | Ysabel Ehryn Meris | Specialist/Technologist | 1250 N Bellflower Blvd, Long Beach, CA 90840 | 2018-02-19 |
1962608604 | Joshua Stone | Specialist/Technologist | 1250 N Bellflower Blvd, Attention Athletic Training, Long Beach, CA 90840 | 2007-06-21 |
1174006787 | Ryan Gray | Physical Therapist | 1250 Bellflower Blvd Kinesiology Building Rm 105, Long Beach, CA 90840-0001 | 2018-09-10 |
1457855421 | Gayle Early | Nurse Practitioner | 1250 Bellflower Blvd School of Nursing, Long Beach, CA 90840-0001 | 2018-03-22 |
1194293472 | Dmitry Foox | Physical Therapist | 1250 N Bellflower Blvd # Et130, Long Beach, CA 90840-0004 | 2018-11-05 |
1639190606 | State of California | Pharmacy | 1250 N Bellflower Blvd, Long Beach, CA 90840-0004 | 2006-07-22 |
Find all providers in zip 90840 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508261256 | Trisha Luu | Physician Assistant | 3300 E. South Street, Suite 308, Long Beach, CA 90805 | 2014-10-23 |
1316284151 | Joan Eastlack | Physician Assistant | 432 Panama Ave, Long Beach, CA 90814-1909 | 2013-01-14 |
1205125267 | Renae C Bright | Physician Assistant | 461 E Broadway, Long Beach #4, Long Beach, NY 11561-4437 | 2011-03-30 |
1881903680 | Monte Carl Burnam Physician Assistant Professional Corporation | Physician Assistant | 1145 E Amelia Dr, Long Beach, CA 90807-2403 | 2010-09-28 |
1912233438 | Wesley Charles Adams | Physician Assistant | 3559 E South St, Long Beach, CA 90805-4519 | 2009-10-19 |
1396920864 | Mohammad A Shadjari | Physician Assistant | 1635 E Ocean Blvd, Apt. F3, Long Beach, CA 90802-6001 | 2008-01-03 |
1760542930 | Paul Scott Margraf | Physician Assistant | 2880 Atlantic Ave Ste 230, Long Beach, CA 90806-1735 | 2006-12-11 |
1669404380 | Bonnie Michelle Moreno Harris | Physician Assistant | 2495 Pine Ave, Long Beach, CA 90806-3029 | 2006-07-06 |
1952850364 | Kaitlyn Vu | Physician Assistant | 2690 Pacific Ave Ste 290, Long Beach, CA 90806-2631 | 2016-09-26 |
1124473178 | Jason Ryan Lomheim | Physician Assistant | 2801 Atlantic Ave, Long Beach, CA 90806-1701 | 2016-04-27 |
Find all providers in LONG BEACH |
City | LONG BEACH |
Zip Code | 90840 |
Please comment or provide details below to improve the information on MRS. ROSEMARY TILMON-KELLUM.
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.