Provider Demographics
NPI:1194882787
Name:MURPHY, KELLY PATRICK (MD)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:PATRICK
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 CUNNINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-1712
Mailing Address - Country:US
Mailing Address - Phone:650-721-2786
Mailing Address - Fax:888-960-8939
Practice Address - Street 1:1835 CUNNINGHAM AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-1712
Practice Address - Country:US
Practice Address - Phone:650-721-2786
Practice Address - Fax:888-960-8939
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG-77540207P00000X
CAG77540207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE88744Medicare UPIN