Provider Demographics
NPI:1932399631
Name:CALLAHAN, KELLY L (MD)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:L
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6430 W SUNSET BLVD
Mailing Address - Street 2:600
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7901
Mailing Address - Country:US
Mailing Address - Phone:323-361-2337
Mailing Address - Fax:323-361-8491
Practice Address - Street 1:4650 W SUNSET BLVD
Practice Address - Street 2:MS#76
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-361-2100
Practice Address - Fax:323-361-8566
Is Sole Proprietor?:No
Enumeration Date:2007-07-28
Last Update Date:2009-02-11
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Provider Licenses
StateLicense IDTaxonomies
CAA98476208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics