Provider Demographics
NPI:1104985845
Name:CURTIS, KELLIE D (MD)
Entity type:Individual
Prefix:
First Name:KELLIE
Middle Name:D
Last Name:CURTIS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4100 GUARDIAN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-6721
Mailing Address - Country:US
Mailing Address - Phone:855-504-4544
Mailing Address - Fax:805-577-2018
Practice Address - Street 1:18436 ROSCOE BLVD
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4107
Practice Address - Country:US
Practice Address - Phone:818-435-1400
Practice Address - Fax:818-435-1492
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2024-04-03
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Provider Licenses
StateLicense IDTaxonomies
CAA96199208600000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No208600000XAllopathic & Osteopathic PhysiciansSurgery