Provider Demographics
NPI:1386916229
Name:MCKELVEY, JAMES ALOYSIUS IV (PA-C)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ALOYSIUS
Last Name:MCKELVEY
Suffix:IV
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:8101 NEWMAN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7042
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8101 NEWMAN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7042
Practice Address - Country:US
Practice Address - Phone:714-698-8580
Practice Address - Fax:714-698-8581
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2012-11-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA22107363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant