MR. MICHAEL JASON KELLEY (NPI# 1912174731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912174731 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL JASON KELLEY |
| Other Name | KELLEY MOBILE MEDICAL SERVICES, LLC |
| Practice Address |
1209 Heatherview Dr Oak Park CA 91377-3914 |
| Practice Telephone | 8188798037 |
| Mailing Telephone | 8188798037 |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2008-07-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669934907 | Michael Francis Kelley Jr. | Student in an Organized Health Care Education/Training Program | 4833 Ithaca St, Metairie, LA 70006-2617 | 2019-04-04 |
| 1588164826 | Michael L Kelley | Registered Nurse | 7760 Margerum Ave Unit 224, San Diego, CA 92120-1441 | 2018-02-13 |
| 1053492397 | Michael E Kelley | Psychologist | 150 W University Blvd, Melbourne, FL 32901-6982 | 2006-10-17 |
| 1649351933 | Michael O'hara Kelley | Marriage & Family Therapist | 690 W Fremont Ave Ste 6, Sunnyvale, CA 94087-4202 | 2006-10-17 |
| 1316053770 | Michael Gaylor Kelley | Dentist | 6296 Rucker Rd, Ste A, Indianapolis, IN 46220-4852 | 2006-08-21 |
| 1558324368 | Michael Ryan Kelley | Optometrist | 2936 E 79th Ave, Merrillville, IN 46410-5748 | 2006-04-11 |
| 1790763704 | Michael Fredrick Kelley | Preventive Medicine | 3009a Highway 30 W, Huntsville, TX 77340-3517 | 2006-01-09 |
| 1306822812 | Michael Timothy Kelley | Preventive Medicine | 1166 Dublin Rd, Suite 400, Columbus, OH 43215-1030 | 2005-12-16 |
| 1376542639 | Michael R. Kelley | Psychologist | 10506 Burt Cir, Omaha, NE 68114-2094 | 2005-07-19 |
| 1265071823 | Michael Dale Kelley | Nurse Practitioner | 129 8th Ave Se, Oelwein, IA 50662-2352 | 2019-12-31 |
| Street Address |
1209 HEATHERVIEW DR |
| City | OAK PARK |
| State | CA |
| Zip Code | 91377-3914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962650424 | Innovative Mobile Services LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1209 Heatherview Dr, Oak Park, CA 91377-3914 | 2008-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396377321 | Rachel Convey | Speech-Language Pathologist | 362 North Oak Hills Dr, Oak Park, CA 91377 | 2020-02-07 |
| 1992254502 | Brenda Pasqua | Emergency Medical Technician, Basic | 899 Kanan Rd, Oak Park, CA 91377 | 2016-09-23 |
| 1093178303 | Paul Hahn | Marriage & Family Therapist | 6843 Poppyview Drive, Oak Park, CA 91377 | 2016-04-04 |
| 1881848554 | Akeomai Physical Therapy, PC | Clinic/Center | 734 Lindero Canyon Road, Oak Park, CA 91377 | 2008-11-07 |
| 1386865988 | Eyal Ron | Radiology | 325 Southridge Dr, Oak Park, CA 91377 | 2007-05-01 |
| 1811079809 | Tracey Burrell | Psychologist | 346 North Kanan Road, 202, Oak Park, CA 91377 | 2006-10-19 |
| 1033421805 | Karen Tenenblatt | Pediatrics | 358 Kanan Rd, Oak Park, CA 91377 | 2010-07-09 |
| 1992203228 | Nancy Raquel Ludwig | Marriage & Family Therapist | 5867 Briarwood Ln, Oak Park, CA 91377-1063 | 2018-02-01 |
| 1083798805 | Tad Alan Erickson | Dentist | 346 Kanan Rd, Suite 101, Oak Park, CA 91377-1100 | 2006-10-25 |
| 1982851812 | Gary Thomas Hardeman | Speech-Language Pathologist | 346 Kanan Rd, #104, Oak Park, CA 91377-1100 | 2008-08-21 |
| Find all providers in zip 91377 | ||||
| Taxonomy Code | 2471C3402X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Radiography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861016883 | Eric Robert Holmgren | Radiologic Technologist | 601 Duboce Ave, North Tower, Level A, San Francisco, CA 94114 | 2020-06-05 |
| 1831657402 | Excel Imaging | Radiologic Technologist | 18158 Us Highway 18, Apple Valley, CA 92307-2202 | 2019-03-03 |
| 1568968899 | Conrado Olalia Quemuel | Radiologic Technologist | 242 Preble Dr, Tustin, CA 92780-3720 | 2018-04-04 |
| 1073036315 | United Mobile Rad LLC | Radiologic Technologist | 1720 E Cartagena St, Long Beach, CA 90807 | 2017-07-19 |
| 1134582083 | Bertha Patricia Orna | Radiologic Technologist | 1206 E 17th St Ste 205, Santa Ana, CA 92701-2641 | 2016-03-29 |
| 1467825703 | Jack Pavich | Radiologic Technologist | 9411 Sunnyside Ave, Ben Lomond, CA 95005-9345 | 2015-11-09 |
| 1306234703 | Socal Surgical Imaging | Radiologic Technologist | 10755 Scripps Poway Pkwy # 709, San Diego, CA 92131-3924 | 2015-01-07 |
| 1013320605 | Hera Nal | Radiologic Technologist | 406 E. Poppy St., Long Beach, CA 90805 | 2014-06-11 |
| 1245643279 | Coastal Diagnostic Services Inc | Radiologic Technologist | 1010 W La Veta Ave Ste 615, Orange, CA 92868-4310 | 2014-06-06 |
| 1003237439 | Amir Nahavandi | Radiologic Technologist | 6206 1/2 Nita Ave, Woodland Hills, CA 91367-7652 | 2014-01-03 |
| Find all providers with the same taxonomy | ||||
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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.