Kellum, Sandra
Kellum, Sandra is an sole proprietor health care provider with primary practice located at 1401 Avocado Ave Ste 802 , Newport Beach CA 92660-7784. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Kellum, Sandra can be contacted via phone (949) 644-0970.Contact Information
Primary practice address
1401 Avocado Ave Ste 802
Newport Beach CA 92660-7784
Phone: (949) 644-0970
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 25MA10083400 | New Jersey |
Profile Details
| NPI number | 1669881397 |
|---|---|
| LBN Legal business name | Kellum, Sandra |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 6th, 2014 |
| Last updated | Nov 13th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669881397 | NPPES |
| New Jersey | Other | 39 | ST. JOSEPH'S HEALTHCARE SYSTEM |
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