Provider Demographics
NPI:1699973578
Name:ARMSTRONG-KELSEY, BRECKEN JAIE (MD)
Entity type:Individual
Prefix:DR
First Name:BRECKEN
Middle Name:JAIE
Last Name:ARMSTRONG-KELSEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BRECKEN
Other - Middle Name:JAIE
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:469 RAMONA AVE
Mailing Address - Street 2:
Mailing Address - City:SIERRA MADRE
Mailing Address - State:CA
Mailing Address - Zip Code:91024-2326
Mailing Address - Country:US
Mailing Address - Phone:626-836-1957
Mailing Address - Fax:
Practice Address - Street 1:1000 W CARSON ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2004
Practice Address - Country:US
Practice Address - Phone:310-222-3501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96864207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine